House of Commons
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Mr Speaker
Before we come to Women and Equalities questions, may I say how proud I was to host an event last night marking The House magazine’s publication of its list of 100 women in Westminster? It was an honour to celebrate so many inspiring colleagues. I wish them and everyone a happy International Women’s Day.
Oral Answers to Questions
(1 year, 9 months ago)
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Munira Wilson (Twickenham) (LD)
The Minister for Women (Maria Caulfield)
Gender pay gap reporting continues to motivate employers to look at their pay data and improve workplace gender equality, and huge progress is being made. The gender pay gap has fallen by approximately a quarter in the past decade, but of course, there is more work to be done.
Munira Wilson
I thank the Minister for her response. An 18-year-old entering the workforce today will not see gender pay equality in her lifetime. With the national gender pay gap at 14% and growing, will the Minister commit this International Women’s Day to ending the motherhood penalty by fixing our broken childcare system and ensuring that every family can access affordable childcare?
Maria Caulfield
Absolutely. It is this Conservative Government who, in 2017, introduced the world-leading regulations that have ensured that we are able to record the gender pay gap and the progress that we are making. We are also committed to the childcare aspect, which is difficult for many women. That is why we have announced additional funding of £160 million this year, £180 million next year, and £170 million the year after for local authorities to increase the hourly rates to pay for childcare, which is so important to women.
Anneliese Dodds (Oxford East) (Lab/Co-op)
Last year, the gender pay gap was 12% higher than it was in 2020, the year in which the Minister for Women and Equalities was first appointed to the Government Equalities Office. If not the Minister, can anyone on the Government Front Bench please apologise to women for that increase this International Women’s Day?
Maria Caulfield
I thank the shadow Minister for that question. It is disappointing that she cannot welcome the progress that has been made, and not just in terms of the gender pay gap: we are supporting pay transparency, which is equally important in making sure women are paid the same as men. We are launching a science, technology, engineering and maths returners pilot to enable 75,000 people to return to the STEM sector, mainly women. On carers’ leave, flexible working and shared parental leave, and through supporting the hon. Member for Bath (Wera Hobhouse) with her private Member’s Bill on harassment in the workplace, there is huge progress on supporting women in work.
Anneliese Dodds
No apology, then, for that increase in the gender pay gap over recent years, and no real action, it seems. Other figures from the Office for National Statistics show that the gender pay gap for women in their 50s and 60s is nearly four times higher than it is for those in their 30s. Some 185,000 women aged between 50 and 64 have also left the workforce since 2020, at a cost of £7 billion to our economy. Will the Minister back Labour’s proposal for larger companies to publish menopause action plans to support women to stay in work, boost productivity and grow our economy, or will that action to support working women again just be dismissed as left-wing?
Maria Caulfield
I am pleased that the Labour party is getting with the programme—that it can actually define what a woman is, for a start. We will not take any lectures from the Labour party; perhaps it needs to get its own house in order before lecturing the rest of the country, because according to The Daily Telegraph in January, the Labour party paid its black workers 9% less than its white workers. It absolutely needs to get its own house in order.
Kirsten Oswald (East Renfrewshire) (SNP)
As I highlighted to the Leader of the House last week, the gender pay gap between women and men currently sits at nearly 15%. We know that women are not a homogenous group, so that gap will vary further based on intersecting characteristics, including ethnicity and disability status. Will the Minister, in line with the theme for this International Women’s Day, embrace equity by mandating gender pay gap reporting and action plans for all employers, as well as introducing ethnicity and disability pay gap reporting requirements?
Maria Caulfield
As I set out, this Government in 2017 set out world-leading regulations requiring larger employers to publish their average salaries, but that does not stop other employers from doing the same. We would have to pass new regulations to reduce that threshold and change the Equality Act 2010, but we are seeing all employers wanting to reduce the gender pay gap, and we are leading the way in government, with the Department for Culture, Media and Sport and the Department for Work and Pensions having eliminated that gap in their Departments.
Wera Hobhouse (Bath) (LD)
The Parliamentary Under-Secretary of State for the Home Department (Miss Sarah Dines)
I am going to have to be quicker, or I will never get on the “Women in Westminster: the 100” list.
The Law Commission recommended against adding sex and gender to the hate crime laws. It found that the addition of those characteristics might make the prosecution of crimes that disproportionately affect women and girls more difficult. The Government share the Law Commission’s concern. Parliament repeatedly voted against making misogyny a hate crime last year, and there are no plans to change.
Wera Hobhouse
I recognise the arguments that have been made. Most violence against women originates in misogyny. Therefore, making misogyny a hate crime would send such a powerful signal to all offenders that all their offences will be taken with the utmost seriousness and investigated properly. Victims of Wayne Couzens have argued that, if only their reports of his indecent exposure had been taken seriously, Sarah Everard might still be alive today. Is it not time that we made misogyny a hate crime?
Miss Dines
I beg to disagree. It may send a signal, but it is more of a virtue signal than a real signal. We have more police officers than ever, and we are determined to stamp out violence against women and girls.
Sir James Duddridge (Rochford and Southend East) (Con)
The Minister for Women (Maria Caulfield)
Health disparities exist across a wide variety of conditions, from cancer to mental health, and contribute to the unacceptable variation in health outcomes. The major conditions strategy that we are launching will therefore apply a geographical lens to end the disparities in health outcomes across England.
Sir James Duddridge
I thank the Minister for that reply, but what does she make of the interesting comments by Sir Chris Whitty about health inequalities in coastal areas, such as Southend, and what are the Government proposing to do about those inequalities?
Maria Caulfield
My hon. Friend is absolutely right that there are disparities. There is an eight-year difference in life expectancy between a woman born in Blackpool and a woman born in Woking, and we want to end that. That is why our major conditions strategy is in parallel with the work that NHS England is doing on its Core20PLUS5, where we are targeting the 20% most deprived populations and the five key health conditions that are making those disparities apparent today.
Martin Docherty-Hughes (West Dunbartonshire) (SNP)
The average life expectancy of a woman with a learning disability is around 18 years shorter than women in the general population, so on this International Women’s Day, what can the Minister say to women with learning disabilities about the disparity in their life expectancy in Britain?
Maria Caulfield
The hon. Gentleman makes a very good point and that is exactly why mental health is part of the major conditions strategy. People with mental health and learning disabilities do suffer from poorer physical health, and that is why it is crucial that we do not see—[Interruption.] If he listened to me, he would have heard that I said “learning disabilities”. It is crucial that we do not see people with a learning disability in isolation, and that we look after their physical health, as well as the conditions they suffer from.
Yasmin Qureshi (Bolton South East) (Lab)
Pregnant women who live in the poorest areas of England are twice as likely to die than those living in the most affluent areas. Shockingly, black women are four times more likely to die during childbirth. This Government have had 13 years, but have failed to tackle maternal health inequalities. What action is the Minister taking to address these appalling disparities?
Maria Caulfield
This is why we have set up the maternity disparities taskforce. We are working with the chief midwife to drive down those disparities, and we are working with NHS England. Maternity is one of those Core20PLUS5 elements, because we recognise that there is huge disparity across the country, which we want to eliminate.
Helen Morgan (North Shropshire) (LD)
The Parliamentary Under-Secretary of State for Energy Security and Net Zero (Amanda Solloway)
The Department is talking to a range of stakeholders to assess evidence and options for a more targeted approach to consumer protection from April 2024.
Helen Morgan
More than 200,000 disabled households, including people in my constituency, lost out on the £150 warm home discount scheme due to a change in who the Government deem entitled to claim. Disabled people often require additional energy to run specialist equipment and to keep their homes warmer. Given that there is no appeals process, will the Minister agree to review that problem in the system and work with hon. Members to address it next year?
Amanda Solloway
The Government have been committed to supporting disabled people—a whole range of people—in the cost of living crisis. As I have mentioned, we will be meeting and discussing it.
Mr Ben Bradshaw (Exeter) (Lab)
The Parliamentary Under-Secretary of State for the Home Department (Miss Sarah Dines)
The Government take all forms of hate crime seriously. We expect the police to fully investigate all those sorts of hateful attacks to make sure that the cowards who commit them feel the full force of the law. We are committed to reducing all crime, including hate crime, which is why we are recruiting 20,000 additional police officers.
Mr Bradshaw
The Minister will know that trans people are already the group most likely to be the victims of violent crime, and there was a massive 56% increase in hate crime against trans people last year. That is against what I conceive to be a background of semi-official transphobia in England, which is similar to the moral panic that led to section 28 in the 1980s. What is her view of the comments of her party’s deputy chairman, the hon. Member for Ashfield (Lee Anderson), who called on the Conservative party to campaign on
“a mix of culture wars and trans debate”?
Miss Dines
With the greatest respect, I do not accept the way that the narrative has been framed about the deputy chairman of the Conservative party. We have to look at all those issues, but I welcome the increase in the reporting of the sort of offences that the right hon. Member mentions, because it is only when people come forward that we can do something about it. The increase to 56% from 43% is a good thing, because it means that people have more confidence in the police. There is more to do, but I certainly do not accept that the Government are against assisting in that area, as has been said. We are putting huge amounts of effort and education into it, from which we will reap the benefits in years to come.
Andrew Lewer (Northampton South) (Con)
The Minister for Equalities (Stuart Andrew)
The Government have taken steps to modernise the application process for obtaining a gender recognition certificate and to make applications more affordable. GRC applicants are now required to pay £5 and the newly developed digital application process for GRCs launched on 29 June.
Andrew Lewer
Does the Minister agree that it is important to have a consistent approach to the recognition of overseas countries’ GRC schemes and that, because of the complex interaction with the Equality Act 2010, it is right to recognise the schemes of only those countries that have equivalent approaches?
Stuart Andrew
A consistent approach to GRCs is fundamental to the effective functioning of legislation in this area. The GB-wide Equality Act was carefully drafted in the light of, and to reflect, the specific limits of the UK-wide Gender Recognition Act 2004. It is important, for the effective functioning of the Equality Act, that the recognition of international GRCs is in line with the basic principles of the GRA.
Jim Shannon (Strangford) (DUP)
I thank the Minister for his response. Many people in Northern Ireland, and the United Kingdom as a whole, have concerns about gender recognition certificates. Has he had an opportunity to talk to some of those organisations to get their opinion, so that we can draw up a policy that is recognised by everyone?
Stuart Andrew
I recognise that this is an area of considerable concern for some, but it is important that the debate is calm and measured, and absolutely respects the individuals involved. I have many meetings with people from around the country on these specific issues, and we take careful consideration of all the points that are made to ensure that everybody feels confident that the law is in the right place.
Edward Timpson (Eddisbury) (Con)
The Parliamentary Under-Secretary of State for Business and Trade (Kevin Hollinrake)
The Department for Business and Trade is keen to support entrepreneurs from all communities, as evidenced by a disproportionately high proportion of start-up loans accessed by ethnic minority-led businesses. The Government have supported actions aimed at improving opportunities for ethnic minority entrepreneurs, as set out in the “Inclusive Britain” report, and we will be reporting back to Parliament shortly.
Edward Timpson
Decision making, leadership, commitment, confidence, resilience, teamwork and self-esteem are all skills and attributes essential to entrepreneurialism. It is also the case that these can be fostered by high-quality physical education in schools, which is why today’s announcement of £600 million over two years to support primary school PE and sport is so welcome. Sport England reported in December:
“Children and young people with Black, Asian and Other ethnicities are the least likely to be active.”
So will my hon. Friend use his good offices to upgrade from Government aspiration to Government policy the Association for Physical Education’s recommendation to make PE a core subject in schools to help tackle this unacceptable disparity?
Kevin Hollinrake
Hear, hear. As someone who benefited from playing football, rugby and cricket at my state school, I am delighted at the announcement that my hon. and learned Friend refers to. My right hon. Friend the Secretary of State for Education has today announced a package of activity to boost equal opportunities in school sport, both inside and outside the classroom.
Ian Levy (Blyth Valley) (Con)
Sir Edward Leigh (Gainsborough) (Con)
The Parliamentary Under-Secretary of State for the Home Department (Miss Sarah Dines)
Tackling violence against women and girls is a Government priority, and something I regularly discuss with my colleagues. We have added violence against women and girls to the strategic policing requirement, meaning it is set out as a national threat for police forces to respond to alongside issues such as terrorism. We have launched the £36 million domestic abuse perpetrator intervention fund to improve the safety and feeling of safety of victims and their children, and to reduce the risk posed by perpetrators.
Ian Levy
It is a sad fact that walking home at night is for too many women and girls a time when they feel exposed to danger, and this is unacceptable. Sadly, for some when they get home, home is not a place of refuge; it a place of danger. During the periods of national lockdown in the pandemic, this became a reality for more women and girls, with the police and domestic abuse support services reporting an increase in cases of victims experiencing abuse in their own homes. Will my hon. Friend advise me what progress has been made in supporting the frontline services?
Miss Dines
I am pleased to be able to say that the Northumbria police and crime commissioner has received £3.7 million from across the safer streets fund rounds to date, and the £750,000 through the current round 4 is for a range of interventions on transport and therapy. Also, we have training for the NHS to make sure we have an all-systems process to improve this; we have better training for those who work in healthcare and in education in a whole-system approach. This Government are committed to assisting.
Sir Edward Leigh
As the father of three young women, like any parent I worry about their safety. Society seems to have become harder, and old-fashioned values of respect towards women seem to be vanishing in many parts of our society, even in the police. What practical efforts can the Government make to make young women feel safe in the streets, particularly in areas of our great cities?
Miss Dines
I know that the Prime Minister has daughters and shares my right hon. Friend’s concerns. I can say that the Lincolnshire police and crime commissioner has received £1.3 million from across the safer streets fund rounds so far, and the almost £400,000 in the current round 4 is for extra CCTV and police training to respond to VAWG. This is part of a wider picture and we are advancing. I am very proud of what the Government are doing.
Rosie Duffield (Canterbury) (Lab)
An Afghan woman is smuggled into the UK on a small boat because she cannot access the resettlement scheme. Once here, she is trafficked into prostitution and abused by a grooming gang. Under the Government’s new Bill, she would be unable to access modern slavery support, and she would be returned to an unsafe country. Does the Minister agree that we must make sure that all vulnerable women are safe from such crimes?
Miss Dines
There is a lot of work going on. We have been engaging with stakeholder groups to see what we can do to make sure that every woman is safe. I have spoken to several groups about this issue, which is being considered. Let no one be mistaken: this Government are extremely strong on making sure that vulnerable women, wherever they come from, are safe.
Samantha Dixon (City of Chester) (Lab)
Sadly, catcalling and other gender-based micro-aggressions are still commonplace in schools. The Chester Sexual Abuse Support Service, which works closely with schools across my constituency, tells me there is still a lack of awareness, education and prevention regarding these issues. What is being done to resource schools to raise awareness and help young people to challenge behaviours that lead to abuse?
Miss Dines
A wide range of work and training is going on within schools to ensure that young people understand more clearly what is and what is not acceptable. On more national interventions, we have the Ask for ANI scheme in pharmacies and the Enough social media campaign, which has really cut through—the responses we have had to that campaign have been unprecedented. This Government are committed to, and making good progress in, assisting young people to understand what is and is not acceptable.
Chris Stephens (Glasgow South West) (SNP)
The Minister for Women (Maria Caulfield)
I wish everyone a happy International Women’s Day, when we celebrate 51% of the population. I am proud of this Government’s record on supporting women, whether that is young girls playing more sport in school or the first ever women’s health strategy, which this year will see the rolling out of the prepayment certificate for hormone replacement therapy, pregnancy loss certificates this summer, and the levelling up of IVF access. Today I am proud to announce £25 million to roll out women’s health hubs across England—the one-stop shop for all women’s health needs that will drastically improve women’s experience of healthcare in England.
Mr Speaker
Order. People cannot walk in front of a Member when he is asking his question.
Chris Stephens
The Minister will be aware of a legal agreement under the Equalities Act between McDonald’s and the Equality and Human Rights Commission over the handling of complaints of sexual harassment. Does the Minister believe that that is solely an issue of a toxic culture at McDonald’s, and will she look at whether women working on zero-hours contracts across the economy are at increased risk of experiencing sexual harassment because of depending on male managers for future shifts?
Maria Caulfield
We take sexual harassment in the workplace very seriously—[Interruption.] Oh, to be shouted down for the entrance of a man.
Mr Speaker
Order. Minister, nobody was shouted down. It happens every time, and when the Prime Minister comes it will happen again. Don’t worry—come on.
Maria Caulfield
I will try again, Mr Speaker. Once again, the Government are keen to tackle sexual harassment in the workplace. That is why we are supporting the private Member’s Bill promoted by the hon. Member for Bath (Wera Hobhouse), the Worker Protection (Amendment of Equality Act 2010) Bill, because it is such a serious issue.
Simon Jupp (East Devon) (Con)
The Parliamentary Under-Secretary of State for Work and Pensions (Mims Davies)
We are working with employers and employees on that crucial matter, to ensure that there is no stigma in the workplace for those experiencing the impact of the menopause. To that end, on Monday I was delighted to announce the appointment of Helen Tomlinson as the Department for Work and Pensions menopause employment champion. She will have a key role in driving awareness and promoting the benefits to both business and the economy of a fully inclusive workplace.
Mick Whitley (Birkenhead) (Lab)
The Parliamentary Under-Secretary of State for the Home Department (Miss Sarah Dines)
Violence against disabled people, in their home or anywhere, is just as important an issue as violence against anybody else, and we are putting unprecedented moneys towards stopping that sort of violence. It is all about education. The National Police Chiefs’ Council and the College of Policing are working hard on that, and we are making progress.
Sir James Duddridge (Rochford and Southend East) (Con)
Maria Caulfield
Absolutely. That is why we are setting out the suicide prevention strategy and looking at high-risk groups such as men. The Home Office is also working to set up helplines for men. Some £200,000 is going into those helplines, and so far they have supported 10,000 men who needed support.
Stephen Morgan (Portsmouth South) (Lab)
Maria Caulfield
The Labour party is once again late to the party, because the Conservative Government are already delivering on this. We have set up the high-growth enterprise taskforce to get more women into setting up high-growth businesses and to end the disparity in venture capital whereby, for every pound that is given, 89p currently goes to men’s businesses and only a penny to women’s.
Mr Speaker
Before we come to Prime Minister’s questions, I would like to point out that live subtitles and a British Sign Language interpretation of proceedings are available to watch on parliamentlive.tv.
Richard Burgon (Leeds East) (Lab)
The Prime Minister (Rishi Sunak)
Today is International Women’s Day. At home, we are taking huge strides to deliver equal opportunities for women, such as mandatory pay gap reporting and the landmark Domestic Abuse Act 2021; and internationally, we have today launched a new women and girls strategy, which puts them at the heart of everything we do.
This morning I had meetings with ministerial colleagues and others. In addition to my duties in this House, I shall have further such meetings later today.
Richard Burgon
Over 100 days ago, the Prime Minister promised to publish his tax returns. He still hasn’t. People want transparency in our politics, especially because the Prime Minister is the richest Prime Minister in history and because of the concerns there have been. So why on earth has the Prime Minister not published his tax returns yet, when will he do so, and when he does so, will he include his US tax returns?
The Prime Minister
As I previously confirmed, I will publish my tax returns, and that will be done very shortly.
Anthony Mangnall (Totnes) (Con)
The Prime Minister
My hon. Friend is right that there is still more work to do to tackle problems with the sector. We are making progress in implementing changes. Park home owners’ rights are now codified in writing with the site owner, and should those obligations not be met, residents can take site owners to a tribunal. Local authorities also now have powers to take enforcement action, and we will continue to support them to improve protection for park home residents everywhere.
Keir Starmer (Holborn and St Pancras) (Lab)
Today, on International Women’s Day, we celebrate the successes of women in our society. It is a crying shame that, as we do so, we face legislation that drives a coach and horses through our world-leading modern slavery framework, which protects women from exploitation. In the last decade, this Government have introduced five plans to tackle illegal immigration—five utter failures. The problem just gets worse with every new gimmick. The Home Secretary says the public are
“sick of tough talk and inadequate action.”
Does the Prime Minister agree with her assessment of this Government’s record?
The Prime Minister
What the right hon. and learned Gentleman fails to recognise is that there is a global migration problem. We are not alone in facing these challenges. It is precisely because, across Europe, the numbers are escalating to the extent they are that we have brought forward new plans, and because we are determined to ensure that this remains a compassionate and generous country and that that is done fairly and legally. That is why we will break the criminal gangs. We have announced new agreements with Albania and France, tougher immigration enforcement and now new legislation that makes it clear that if you come here illegally, you will be detained and swiftly removed. But what we have not heard is the right hon. and learned Gentleman’s plan. We know what it is: it is open-door immigration and unlimited asylum. While he may be on the side of the people smugglers, we are on the side of the British people.
Keir Starmer
If the Prime Minister was serious about stopping the boats, he would steal our plan on stopping the boats, smash the gangs, sort out the returns and clean up the utter mess. [Interruption.]
Mr Speaker
Order. I am going to hear this, and nobody is going to—[Interruption.] I wouldn’t if I were you. I think we have heard enough. I want to hear the questions and the answers. They will not be interrupted.
Keir Starmer
Nobody on the Labour Benches wants open borders. Those on the Conservative Benches have lost control of the borders. The Prime Minister promised the country that the Bill will stop all small boat crossings, no ifs, no buts. It sounds like more talk, so in the interests of adequate action, when will he achieve that?
The Prime Minister
We will be implementing the plan as soon as we can pass it through Parliament, so I look forward to the right hon. and learned Gentleman’s support. The reality is that he has been on the wrong side—[Interruption.]
Mr Speaker
Order. Mr Stafford, if you don’t want to hear the Prime Minister you can go and have a good cup of tea, nice and strong I suspect, but I will hear him.
The Prime Minister
The right hon. and learned Gentleman has been on the wrong side of this issue his entire career. He described all immigration law as “racist”, he said it was a mistake to control immigration and he has never, ever voted for tougher asylum laws. It is clear that while he is in hock to the open border activists, we are on the side of the British people.
Keir Starmer
When I was in charge of prosecutions, I extradited countless rapists and the conviction rate for people smuggling was twice what it is today. I voted against the Prime Minister’s legislation last time because I said it would not work. Since it became law, the numbers have gone up: he has proved me right. He should be apologising, not gloating. The Prime Minister says the Government will detain people who are not eligible to claim asylum here and then return them. Well, they already tried that under the last legislation. Last year, 18,000 people were deemed ineligible to apply for asylum—that is the easy bit, the talk—but as for the action, Prime Minister, how many of them have actually been returned?
The Prime Minister
As a result of the plans we have brought forward, we have almost doubled the number of people returned this year. The right hon. and learned Gentleman talked about laws—[Interruption.]
Mr Speaker
Order. I think the Front Benchers need to be a little quieter. I want to hear and I do not need you joining in. Our constituents want to hear Prime Minister’s questions, both the questions and the answers. Show our constituents the respect they are due. Come on, Prime Minister.
The Prime Minister
The right hon. and learned Gentleman asked about our laws. Actually, when I was in Dover yesterday talking to our law enforcement officials, what did they tell me? That precisely because of the law the Conservative Government passed last year, they have now been able to arrest more than double the number of people they did before: 397 in the last six months. But stopping the boats is not just my priority; it is the people’s priority. His position is clear: he wanted to, in his words, scrap the Rwanda deal, he voted against measures to deport foreign criminals, and he even argued against deportation flights. We know why, because on this matter—he talked about his legal background—he is just another lefty lawyer standing in our way. [Interruption.]
Mr Speaker
Order. We will continue. When you keep shouting, it prolongs things. Some of you are trying to catch my eye. When you are disappointed, I do not want any complaints. Let us get through these questions, so we can get some Back Benchers in.
Keir Starmer
All that nonsense because the Prime Minister does not want to answer the question. He knows what the answer is. The number is 21. I thought he was a man of detail. The number is 21—21—people out of the 18,000. What happens to the rest? They sit in hotels and digs for months on end at the taxpayer’s expense. Last year he promised to end the hotel farce—that is the talk—but because of his mess there are thousands of people who cannot claim asylum and cannot be returned, so where does he actually think they are going to end up?
The Prime Minister
The right hon. and learned Gentleman talks about the pressure on our asylum system, but we have a clear plan to stop people coming here in the first place. Labour Members have absolutely no plan on this issue because they simply do not want to tackle the problem. We introduced tougher sentences for people smugglers—they opposed it. We signed a deal with Rwanda—they opposed it. We are deporting foreign offenders as we speak—they oppose it. [Interruption.]
Mr Speaker
Order. The hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) should save that good voice for the rugby match. She might be able to join Mr Stafford for that strong cup of tea.
The Prime Minister
In fact, the right hon. and learned Gentleman opposed every single step of what we have done to try to stop the problem. We know his only contribution to this debate—in his own words:
“We will defend free movement.”
That is the Labour party for you.
Keir Starmer
The Prime Minister stood there last year saying exactly the same thing. We said that it would not work; the Government passed the law and the numbers went up. Absolutely deluded. He cannot say where they will return people, because they spent £140 million on Rwanda and it does not work. They cannot say how they will return people because the Bill does not come with a single new return agreement. They cannot say when they will fix the mess because it is more talk, more gimmicks and more promises to be broken. A few months ago, I put to the Prime Minister that of the people who arrived on small boats, only 4% had been processed. He stood there and said that that was unacceptable. What is the number now?
The Prime Minister
As a result of what we have done, there are now 6,000 fewer people in the asylum case load backlog. We are hiring more caseworkers and we are increasing their productivity. Again, the right hon. and learned Gentleman is mistaken when it comes to returns, because we have returns agreements with India, Pakistan, Serbia, Nigeria and—crucially—now with Albania, where we are returning hundreds of people. Our position is clear: if you arrive here illegally you will not be able to claim asylum here, you will not be able to access the modern slavery system and you will not be able to make spurious human rights claims. That is the right thing to do. The right hon. and learned Gentleman is going on and on about process and hiding behind it because he does not want to confront the substance. We are the party of fairness. He represents the party of free movement.
Keir Starmer
I thought that the Prime Minister was supposed to be a man of detail, but he has gone to all those lengths to avoid the detail. He knows the answer to the question—less than 1% of those who arrived by boat have been processed. [Interruption.] He shakes his head, but that is the Government’s own statistic. On his watch, processing of those boats cases has gone from “unacceptable”, in his words, to almost non-existent. Does that not tell you everything you need to know? After 13 years, small boat crossings are higher than ever; claims are unprocessed; the taxpayer is paying for hotel rooms. Criminal gangs are running, laughing all the way, to the bank. The asylum system has been utterly broken on his watch.
This is the Government’s fifth Prime Minister, their sixth immigration plan and their seventh Home Secretary. After all this time, all they offer is the same old gimmicks and empty promises. I do not agree with the Home Secretary on very much, but when she says that the Tories are “all talk and no action,” she is spot on, is she not?
The Prime Minister
Illegal immigration enforcement—up. The amount of people processing claims—up. The backlog is down. The number of returns agreements is up. Hundreds of people have been returned to Albania, and now we have new laws to detain and deter illegal migrants. It is clear what we stand for. We are doing what is right: we are acting with compassion, we are acting with fairness and we are acting to respect the laws and borders of our country. We are delivering on what we said. It is crystal clear from listening to this that it will be the Conservatives, and only the Conservatives, who stop the boats.
Miriam Cates (Penistone and Stocksbridge) (Con)
The Prime Minister
I share my hon. Friend’s concerns and thank her for her work in this area. That is why I have asked the Department for Education to ensure that schools are not teaching inappropriate or contested content in relationships, sex and health education. Our priority should always be the safety and wellbeing of children. Schools should also make curriculum content and materials available to parents. As a result of all this, we are bringing forward a review of RSHE statutory guidance and will start our consultation as soon as possible.
Stephen Flynn (Aberdeen South) (SNP)
On International Women’s Day, can I ask the Prime Minister to reconfirm that under his proposed new asylum laws, a woman who is sex-trafficked to the UK on a small boat by a criminal gang will not be afforded protection under our modern slavery laws?
The Prime Minister
It is precisely because we want to target our compassion and our resources at the world’s most vulnerable people that we must get a grip on this system and break—
Hon. Members
Mr Speaker
Order. Can I say to SNP Members that it is quite right that questions are asked, but I also want to hear the answers? Shouting from up there is not helping anybody.
The Prime Minister
As I was saying, it is precisely because we want to target our resources and our compassion at the world’s most vulnerable people that we need to get a grip on this system, make sure that we have control over our borders and make sure that our system and resources are not overwhelmed, so that we can help the people most in need. There is nothing fair and there is nothing compassionate about sustaining a system in which, as we saw recently, people are dying on these crossings. That is not right, and our plans will stop that from happening. [Interruption.]
Mr Speaker
Order. Mr McDonald, I do not need to hear you chuntering all the way through. You could be joining the others for a cup of tea.
Stephen Flynn
I will take that as a yes from the Prime Minister that women who are victims of sex trafficking will not be protected under our modern slavery laws. What a complete and utter disgrace. But while it may shock, it should not necessarily surprise, because this is the Tory Government who in recent months have spoken of “invasions”. Just yesterday, this Tory Government said that 100 million people could be coming to these shores. This morning, this Tory Government said that the number could in fact be billions. That is complete and utter nonsense. May I ask the Prime Minister: from whom are his Government taking inspiration, Nigel Farage or Enoch Powell?
The Prime Minister
What a load of nonsense. In fact, the figure of 100 million does not come from the Government; it comes from the United Nations, and it illustrates the scale of the global migration crisis with which the world is grappling. That is why it is right that we take action: because if we do not, the numbers will continue to grow. They have more than quadrupled in just two years. It is a sign of what is to come, and our system will continue to be overwhelmed. If that happens, we will not be able to help the people who are most in need of our support, our generosity and our compassion. This has always been the way of this country. Once we get a grip on this system, that is who we can extend our support to, and that is why it is the right legislation.
Philip Dunne (Ludlow) (Con)
The Prime Minister
I am proud of our commitment to scaling up renewable energy sources. Renewables make up nearly 40% of our electricity supply, which represents a fourfold increase since 2011. My right hon. Friend will know that I cannot and will not pre-empt Budget decisions, but he is a powerful champion for the environment in this House, and I have no doubt that he will make his views known to the Chancellor.
Ed Davey (Kingston and Surbiton) (LD)
Following the tributes relating to International Women’s Day, I want to pay a special tribute to the women in the House, past and present, who have helped to shape the future of our country.
When Jean rang 999, she was told that she would have to wait at least eight hours for an ambulance, so she got into her car and drove herself to Eastbourne District General Hospital. She paid for parking and made it to the entrance to A&E, where she collapsed. Jean died an hour later. No one should lose their mother or their grandmother like that. Will the Prime Minister apologise to Jean’s family, and to all those who have lost loved ones owing to the Government’s appalling ambulance delays?
The Prime Minister
Of course my thoughts and condolences go to Jean’s family. It is absolutely right that we continue to make progress on improving performance in urgent emergency care. We outlined plans to do that just the other month, and I am pleased to say that we have been seeing a marked improvement over the last few weeks in comparison with the peak pressures that we saw over the winter, owing to covid and flu, both in waiting times in A&E and in ambulance performance times. Because of the investments that we are making in more ambulances, more doctors and nurses, and more discharges, I am confident that we will continue to make progress towards securing the care that we all expect and need to see.
Jo Gideon (Stoke-on-Trent Central) (Con)
The Prime Minister
Community focus banks and non-bank lenders such as Burnley Savings and Loans have a vital role to play in ensuring that everyone has access to affordable credit. That is why we have made it quicker and easier for new banks to enter the market. Since the new bank start-up unit was created a few years ago, 30 new banks have been authorised. I will ensure that my hon. Friend has a meeting with the Exchequer Secretary to discuss this issue further.
Kevin Brennan (Cardiff West) (Lab)
The Prime Minister
We have introduced measures to combat ticket-touting, but I shall be happy to listen to the documentary that the hon. Gentleman has mentioned to ensure that we are doing everything we can do, and I will talk to the Home Secretary about it. More generally, it is a source of enormous pride for us to host Eurovision. I know that everyone is looking forward to it. We should ensure that access to it is as broad as possible, and we will do all that we can to make certain that that happens.
Mr David Davis (Haltemprice and Howden) (Con)
The Prime Minister
Obviously it is in our national interest to have effective extradition relationships. Under the treaty we have with the US, we have secured the extradition and subsequent conviction of terrorists, murderers, rapists and child sex offenders. I am happy to meet my right hon. Friend to discuss this issue further. As he knows, the US has refused, I think, one UK extradition request and the UK has refused 27, but I know that he has concerns and I would be happy to meet him to discuss this matter further.
Kenny MacAskill (East Lothian) (Alba)
The Prime Minister
As someone who represents a rural constituency with many people off the gas grid, I appreciate the concern that the hon. Gentleman raises. That is why this has always been uppermost in the Government’s mind as we have designed and implemented our support for people with energy bills, notably by basing it on electricity meters rather than gas, but also by putting in place the alternative fuels support payment of £200. We are making sure that that gets to everyone who needs it.
Mr Richard Bacon (South Norfolk) (Con)
The adjustments to the dental contract last November were a welcome step, but there is more work to do. Will the Prime Minister therefore keep this area under the closest review to ensure that constituents such as mine in South Norfolk and those of other hon. Members get the best possible dental care?
The Prime Minister
My hon. Friend raises an excellent point. I can tell him that we are continuing to invest in NHS dentistry, with £3 billion a year, and we have also enabled practices to do 10% more activity on top of their contracts and removed the barriers so that hygienists and other therapists can continue to work to their full skillset. The number of NHS dentists has increased by about 500 over the last year and we will continue to work with the sector to see what more we can do.
Rosie Duffield (Canterbury) (Lab)
The Prime Minister
The hon. Lady makes an excellent point and I wholeheartedly agree with her. These are important questions, and voters deserve to have clear and straightforward answers to them. I hope that she can continue to put her campaign forward. She will have my full support, and I hope that in the local elections we can debate these issues in the way that they should be debated.
Chris Clarkson (Heywood and Middleton) (Con)
Last weekend, I had the pleasure of being auctioned off for the Conservative Women’s Organisation. On this International Women’s Day, will my right hon. Friend join me in paying tribute to the excellent work that the CWO does to get more Conservative women into politics, and to all the remarkable women who support us in the work that we do, especially—because she is in the Gallery—my mum?
The Prime Minister
I congratulate my hon. Friend on his successful auction. I assume that it was not his mother who bid for him successfully. I pay tribute to her and to the Conservative Women’s Organisation for the fantastic work that it does. We need more women standing in local and national politics, and everyone who is working to bring that about deserves our praise and thanks. Long may that continue.
Richard Thomson (Gordon) (SNP)
The Prime Minister
The Government take the gender pensions gap incredibly seriously. We have delivered groundbreaking pension reforms and major progress. Automatic enrolment has helped millions more women to save into a pension, and pension participation among eligible women in the private sector was 87% in the last available year, up from just 40% a few years ago. We remain committed to the measures in the 2017 review and will continue to give this issue all the attention it deserves until we close the gap.
Lia Nici (Great Grimsby) (Con)
Grimsby Town football club have reached the quarter finals of the FA cup. The last time the team achieved this was in 1939, which by coincidence was the previous time the town had a Conservative MP. Grimsby beat the Prime Minister’s team, Southampton, to get to this next stage, but will he join me in congratulating the team and wishing them the best of luck when they play against Brighton & Hove Albion?
The Prime Minister
Although it pains me, I congratulate my hon. Friend and Grimsby Town on their victory over Southampton. I now have a new team to support in the cup, and my hon. Friend will have my full support. I wish Grimsby well in their next match, and I look forward to cheering with my hon. Friend and all her colleagues.
Steve McCabe (Birmingham, Selly Oak) (Lab)
The Prime Minister
I praise the work of our community pharmacies, which are fantastic at delivering primary care on the frontline. As I have said previously, the Government are exploring ways in which we can support them to do even more, because improving access to pharmacies is something that people would welcome, and it would help people to get the care they need faster and more efficiently. We will continue to look at all the proposals we have received.
Kelly Tolhurst (Rochester and Strood) (Con)
For more than two years, an illegal waste site has been operating in the village of Borstal. Tipper lorries with covered numberplates thunder to the site at all hours of the day and night, blighting the lives of residents nearby and creating untold environmental damage. I thank the Department for Environment, Food and Rural Affairs team for their engagement with the Environment Agency so far, but no action has been taken. Does my right hon. Friend agree that enough is enough, and that swift, multi-agency action should be taken to stop and shut down such illegal and criminal activities?
The Prime Minister
I thank my right hon. Friend for raising this issue. The Government are committed to tackling waste crime, and the joint unit for waste crime brings agencies together in the way she describes. I am aware that she has met the local Environment Agency director about this particular issue, but I will ensure that she gets a meeting with the relevant Minister to discuss it further.
Matt Rodda (Reading East) (Lab)
The Prime Minister
I am very sorry to hear about the case that the hon. Gentleman raises. My thoughts are with Olly’s family.
The hon. Gentleman is absolutely right that we should do everything we can to tackle the scourge of knife crime. That is why, for instance, this Government brought forward new powers to improve the police’s use of stop and search, which has made a major difference. Violent crime is now down considerably over the past few years. The Online Safety Bill goes further than any other country has gone to make sure we protect children online. I am happy to look at the specific issue he mentions, but the Bill has been praised by the Children’s Commissioner and others as a groundbreaking law that will do wonders to improve children’s safety.
Daniel Kawczynski (Shrewsbury and Atcham) (Con)
The Secretary of State for Environment, Food and Rural Affairs will be visiting Shrewsbury at the end of this month, at my invitation, when she will hear of the tremendous progress made to date by the River Severn Partnership and the Environment Agency in trying to find a holistic solution to managing Britain’s longest river, the River Severn. We are now experiencing flooding in Shrewsbury on an annual basis, with tremendous economic damage as a result. Will the Prime Minister take an interest, please, and secure additional funding for the Department for Environment, Food and Rural Affairs, so that we can finally tame these rivers and protect our communities from annual flooding?
The Prime Minister
My hon. Friend has raised this issue before, and he is right to do so. The Government have doubled our investment in flood defences over this Parliament, to £5.2 billion. I know that the DEFRA Secretary will talk to him and his communities on her visit, and I look forward to hearing back from her after that.
Gerald Jones (Merthyr Tydfil and Rhymney) (Lab)
The Prime Minister
The exact stats are that, since 2010, 1.2 million fewer people are in poverty, because of the actions that this Conservative Government have been putting in place, such as raising the national living wage. The best way to ensure that children, especially, do not grow up in poverty, is to ensure that they do not grow up in workless households. As a result of the actions of this Government in getting people into work, there are now several thousand fewer workless households than there were in 2010.
Mrs Natalie Elphicke (Dover) (Con)
It was a great pleasure to welcome the Prime Minister to Dover to talk about the work he is undertaking on the pull factors in tackling illegal immigration. The Prime Minister has a meeting with President Macron this week, so may I ask him to see what more can be done to deal with the push factors associated with illegal migration and small boats—pushing those boats across French beaches and pushing those boats from French beaches into the French sea?
The Prime Minister
As I have said before, no single lever will solve this problem, which is why it is right that we work on all the different things that will make a difference, including close co-operation with the French. That is why I was pleased at the end of last year that the Home Secretary and I announced the largest ever small boats deal with France, with a 40% increase in patrols and greater co-operation. We look forward to strengthening that co-operation and furthering that discussion this Friday.
Imran Hussain (Bradford East) (Lab)
The Prime Minister
It is precisely because we want to help the world’s most vulnerable people that we must stop our system being exploited and overwhelmed by illegal migrants who are being trafficked here by criminal gangs. There is nothing compassionate or fair about supporting that system continuing, which is why our new laws are the right way to deal with this. I hope that the hon. Gentleman can see that and support them.
Anna Firth (Southend West) (Con)
This morning, on International Women’s Day, I joined some of the amazing young women at Our Lady of Lourdes Catholic Primary School in Leigh-on-Sea to take part in the Football Association’s Let Girls Play football campaign. Does my right hon. Friend agree that sport, and football in particular, is a brilliant way to empower young women? Will he visit Southend and celebrate some of our aspiring Lionesses?
The Prime Minister
My hon. Friend makes an excellent point, and I wholeheartedly agree with her. I hope that I will be able to come to visit her. She is right about the power of sport to both engage young women and inspire others. I am looking forward to seeing the Lionesses later today, and the Government are pleased to announce today more funding and more support for sport in schools, which I hope she will warmly welcome.
Tahir Ali (Birmingham, Hall Green) (Lab)
The Prime Minister
This Government have a proud record of standing up for women and girls across the world. We have led the way in preventing sexual violence in conflict, and are taking a lead on ensuring that tens of millions of girls in some of the poorest parts of the world receive the high-quality education that they deserve. Just today, we have announced a new women and girls strategy from the Foreign Office and backed that up with £200 million more to support women’s health around the world. That continues our leadership on this issue, which will remain the case.
Bill Presented
Data Protection and Digital Information (No. 2) Bill
Presentation and First Reading (Standing Order No. 57)
Secretary Michelle Donelan, supported by Secretary Suella Braverman, Secretary Steve Barclay, Secretary Kemi Badenoch, George Freeman, Julia Lopez, Paul Scully and Alex Burghart, presented a Bill to make provision for the regulation of the processing of information relating to identified or identifiable living individuals; to make provision about services consisting of the use of information to ascertain and verify facts about individuals; to make provision about access to customer data and business data; to make provision about privacy and electronic communications; to make provision about services for the provision of electronic signatures, electronic seals and other trust services; to make provision about the disclosure of information to improve public service delivery; to make provision for the implementation of agreements on sharing information for law enforcement purposes; to make provision about the keeping and maintenance of registers of births and deaths; to make provision about information standards for health and social care; to establish the Information Commission; to make provision about oversight of biometric data; and for connected purposes.
Bill read the First time; to be read a Second time tomorrow, and to be printed (Bill 265) with explanatory notes (Bill 265-EN).
Estimates Day
SUPPLEMENTARY ESTIMATE 2022–23
Adult Social Care
(1 year, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Clive Betts (Sheffield South East) (Lab)
I thank everyone concerned for the opportunity to lead this debate on behalf of the Levelling Up, Housing and Communities Committee. Adult social care is an important issue, which the Committee has come back to on several occasions.
Last year, we produced another report on long-term funding for adult social care. We were happy to receive letters, in the last couple of days, from the Under-Secretary of State for Levelling Up, Housing and Communities, the hon. Member for North East Derbyshire (Lee Rowley), and the Minister for Health and Secondary Care, the hon. Member for Colchester (Will Quince), both saying why they have not yet responded to the report that was produced around nine months ago.
As you know, Mr Speaker, the advice is that Government should respond to Select Committee reports within eight weeks, so eight months seems rather a long time. I know that there have been quite a few changes of Minister during that period, so perhaps that explains some of the delay. If this was just a one-off, it would probably be excusable, but the Select Committee rarely gets a response within months, let alone weeks, of a report being produced, which is a little frustrating when we have put so much effort into them. We have not even had a proper response to the joint report that we produced with the Health and Social Care Committee back in June 2018—almost five years ago, which must get near a record for non-responses to Select Committee reports. The Health and Social Care Committee has also done its own reports into these matters, as have many reputable organisations, such as The King’s Fund.
Given the nature of the debate, I will concentrate on the impact on local government funding. Although social care, as a responsibility, lies with the Department of Health and Social Care, it is ultimately delivered through funding from local councils. I want to concentrate on the challenge that that poses for councils. This is not a new matter and is not without a lot of commitments. Only last year, the right hon. Member for South West Norfolk (Elizabeth Truss) said that she would spend £13 billion raised by the levy on social care. Well, the levy seems to have disappeared into other uses, as has the £13 billion.
The right hon. Member for Uxbridge and South Ruislip (Boris Johnson) said:
“I am announcing now—on the steps of Downing Street—that we will fix the crisis in social care once and for all”.
Not to be outdone, the right hon. Member for Maidenhead (Mrs May) said that her Ministers
“will work to improve social care and will bring forward proposals for consultation.”—[Official Report, 21 June 2017; Vol. 626, c. 35.]
Let us go back a bit further. David Cameron said:
“A commission will be appointed to consider a sustainable long-term structure for the operation of social care.”—[Official Report, 25 May 2010; Vol. 510, c. 31.]
I will not just be party political in this, because Gordon Brown said:
“Alan Johnson and I will…bring…new plans to help people to stay longer in their own homes and provide greater protection against the costs of care.”
The one thing that Prime Ministers have in common over the years is that they all promise to deal with the problems and funding of social care. The other thing that they have in common is that none of them has actually done that, and that is something of concern and it is why we still have the problems today.
Let me put this in the context of local government funding. Local government has had the biggest cuts of any part of the public sector since 2010. The National Audit Office and the Library have produced some interesting figures, which are known to be authoritative. They have said that the cut in core spending power for councils in the decade after 2010 has been 26%. By comparison, the increase in funding for the Department of Health and Social Care has been 14%. So that is 26% down for local government and 14% up for the Department of Health and Social Care. I am not begrudging the extra spending on health, but, clearly, councils also do important work and that is not really reflected in the figures.
The reason for that cut in spending power is that the revenue support grant has fallen by 37% over that similar period. A 25% increase in council tax has helped cover some of that fall. Council tax spending as a percentage of total local government spend—the percentage funded by council tax—has gone up from 41% of local government spend to 60%. In other words, council tax has been going up as the Government grant has fallen, but the totality of spending has fallen as well.
Councils’ spending on social care—social care as a whole, including children’s care—has risen by 8.9% in real terms, but non-care spending by authorities has fallen by 32%. That is the knock-on effect—we must keep reminding ourselves of the consequences of this. Social care spending has now roughly risen from 50% of council spending to 60% over the period. Those are very dramatic changes in how councils spend their money.
Let us look at services such as planning. I know that they are important for the future of our country, for future growth and for regeneration. Spending by councils on planning has fallen by about 50%. That is a staggering fall. There have been similar falls in regeneration and economic development, which will be important for the levelling up agenda.
Let us look now at libraries, buses and street cleaning, which are important services that everyone tends to use in some way. They have all fallen by between 30% and 50%. The real challenge for local democracy—the Minister on the Front Bench has responsibility for local government—is that people are now finding that their council tax is going up by amounts that I have just described, but, if they or their immediate relatives do not use social care, they are seeing all the services that they receive fall. That is a fundamental challenge for local democracy—people pay more and get less. That is not defensible in the medium term, but it has been going on for 10 years now, and something has to give.
We might think, “Well, it’s alright as long as social care is sorted out,” but it is not, is it? Let us just look at the particular problems with social care and social care funding. Before the autumn statement last year, the Local Government Association said that it thought that about £7 billion was the shortfall currently. I appreciate that the Minister will no doubt advise us of all the goodies that were delivered in the settlement for the next financial year, and, clearly, there were some helpful increases of money, but not the £7 billion that local councils were looking for. The problem is that that settlement contains some of the elements of the problems that we have been experiencing for a decade or longer now. First, so much of the funding councils get is short-term. Yes, the better care grants and the social care grants are welcome, but much of it is on a one-off basis. Much of last time’s settlement was on a one-off basis, with the extra money coming in those forms of grants, together with the increases in council tax I mentioned previously.
We know there are two fundamental problems with increases in council tax: first, they raise far more money in the most affluent communities than in the poorest communities, and secondly, they are regressive—not my word, but the Secretary of State’s. I know the Minister has been charged with finding a solution to that problem. Good luck to him—we look forward to his report in due course, and we had an interesting dialogue with him in the Select Committee the other week. We are asking more from people on low incomes with proportionately lower house values, and giving less to the poorest communities through the increases. That is not the best way to fund social care in the longer term.
We know that, although funding has been going up, demand is rising. There are more unhealthy people in our communities, as we all know; we can see the figures for ourselves. Often forgotten, however, is the rising demand from people with disabilities. People with a whole variety of disabilities, both learning and physical, are living longer. Where they might have died in their 30s, they are now very often living into their 50s, to the point where parents who once looked after them can no longer help or support them. Those parents are worried sick about what will happen to their children when they no longer have that parental support available. That demand must also be met and recognised.
Barbara Keeley (Worsley and Eccles South) (Lab)
Will my hon. Friend reflect on the fact that, when local authority spending on social care is squeezed and the demand goes up, as he describes so well, the work of caring is then passed on to unpaid carers, such as the parents of the people with disabilities he talks about? Last week, the King’s Fund reported that the number of unpaid carers receiving direct support from local authorities fell by 7% from 2020 to 2021. Does he agree that unpaid carers are being failed by this squeeze and the inadequate local authority funding, and that the Government need to do more to improve that and ensure that carers are properly supported?
Mr Betts
That is a great point from my hon. Friend. We recognise that that care is generally provided with a lot of love and commitment from people who do it, but very often they will reach breaking point without the additional support from local authorities, such as respite care. Families say to me, “If only I could just have a week where I could go away and relax a bit, knowing the person I am caring for is being looked after, that would make an enormous difference.” Sometimes that does not exist anymore, so that is an important point.
Bob Blackman (Harrow East) (Con)
The hon. Gentleman is giving a very clear explanation of local government funding, and I would expect nothing less from the Chair of the Select Committee. However, there is another issue he has not yet covered in his speech, and I am not sure whether he plans to: does he agree that another problem is the other source of income for local government, non-domestic or business rates? I well remember a certain hon. Lady from the Opposition saying in the Select Committee that we are going to get to a position where the non-domestic rates are paying for social care. Is that the right way to utilise business rates?
Mr Betts
The hon. Gentleman makes a good point, and he has been through some of those discussions on the Select Committee—I think the County Councils Network also made that point strongly to us—so he is absolutely right. I was not going to go too much into the long-term reforms of local government funding, but as a Committee we have said that there is a real challenge with the reforms of both council tax funding and business rates, and we have produced reports on that. There is not a clear linkage between how much money a council might get in from business or non-domestic rates and how much demand for social care is going up. Demand for social care is going up that much faster and the tax base needs to be adapted to recognise that, so his point is an important one.
To some extent, that demand is being met by tightening the rules on exemptions. More and more people who would have got social care in the past do not get it now. Age UK says it is 1.5 million—an estimate, but probably not an unreasonable one. There is also less prevention work going on, which means that people who have small needs to help them live in their homes do not get those needs addressed until they become serious needs. Then they end up in hospital, which is much more expensive and a much worse outcome for the people concerned. It results in more pressure on the NHS, more cost and a less good service.
On the other hand, there is the pay and conditions for care staff. People doing the same job in care get less money than people in the NHS. That is true of nurses, for example, where we can make direct comparisons. We know that up to half of care staff tend to leave within a year, and many are on zero-hours contracts. There have been repeated requests for a long-term workforce plan. There has rightly been a request for a long-term plan for the health workforce, but we need one for the social care workforce as well. I think that the Chancellor, the right hon. Member for South West Surrey (Jeremy Hunt), when he chaired the Health and Social Care Committee, argued that case very strongly, and quite rightly.
There is a question of pay: these are skilled people with a real commitment that should be recognised, and not at a minimum pay level. There should be a system with proper career progression and training, so that people can realise the benefits of their skills and commitments. There is evidence that the care market is broken, that many care providers have gone out of business or struggled over the years and that the level of fees in some areas probably does not reflect their costs.
Then, of course, we have the issue of people having to give up their homes to pay for their care costs. It is a complete lottery. If in the end someone finishes the last years of their life with dementia, much of the value of their home will go to pay for their care. If they finish their life by having a heart attack and dying, they do not pay anything towards their care. That is an unfair system and it needs to be addressed. The Dilnot reforms have been around for some time. They have been nearly started and then not started, and nearly started again and not started; I will refer in a couple of minutes to how we might take things forward.
How might we change things to improve them, then? This debate is not just about making complaints; it is about providing solutions. I accept that, and that is what the Select Committee is trying to do. One suggested solution is, “Well, just amalgamate it—let’s have one big service. Put it all in the NHS and it’ll all be all right.” I think most would say that the NHS has enough challenges at present without taking on another great challenge on top. What we do not need is another mass reorganisation affecting both health and social care, the cost of which would probably be a lot more than the cost of doing things any other way.
We should also remember that most people receiving care receive it not in a hospital or even in a care home, but in their own homes. The link that councils can make between their home service, providing adaptations and the like, and care, is key in that regard. The other thing I would say is that we cannot carry on relying on short-term fixes, with one-off grants here, one-off grants there, and a council tax system that is regressive and not fit for purpose, let alone for long-term funding of social care—or, as the hon. Member for Harrow East (Bob Blackman) said a few minutes ago, business rates, which bear little relation to demand for social care either.
I go back to the 2018 joint report with the Health and Social Care Committee, in which we said two things. We did a lot of work with the focus group on this question and spent a lot of time on weekends away in a hotel in Birmingham. What people said was, “If we knew the money was going to social care, we would happily pay more.” That is what happens in Germany and Japan, two countries that we looked at. We said, “Let’s have a social care premium.” Immediately, it might be said that that is not dissimilar to the Government’s proposed increase in national insurance rates. The difference was that, at the time, we said that we had to target any payments. There will be different ways of doing this, I accept, but there has to be a way of raising extra money for social care that neither comes from the current local government system, nor takes care out of local government.
We said that there should be a social care premium as a percentage of income, but that we would raise the bottom level so that the poorest people would not pay. We would increase the top level in the way that national insurance does not, so that people on the highest incomes would continue to pay, and we would include unearned income and higher-level private pensions, but we would also exclude the under-40s, as they do in Japan. We felt that people under 40 were probably getting the worst of the deal after the financial crash in terms of the impact on their finances. That is how we thought we could raise the funds, and it was agreed by the 22 members of the two Select Committees as a way forward.
What is sometimes missed, and what we also suggested, is that we have to deal with the issue of people’s homes being sold. I have to say to the Government that their arrangements to try to implement Dilnot are complicated and unfair. People may not pay until their assets reach a minimum level, but—and I have never heard a Minister address this point—the Government cap the amount that people pay in such a way that people with lower value houses pay a bigger percentage of their homes than people with the highest value houses.
Someone who has a home worth half a million pounds pays a much smaller percentage than someone who has a home worth £100,000. That is not fair, so our Select Committee said that a percentage should just be taken from everyone’s estate. Then, the people with the most would pay the most, and the measure would not be confined to people who need care. That removes the unfairness of people with dementia paying all or most of the value of their home while those who do not have dementia paying nothing. With a small amount of inheritance tax, or another way of assessing people’s estates, we could raise a lot of money and deal absolutely with the problem of people having to give up most of their home to pay for their care costs. That is certainly worth a look.
We need to find a long-term solution to the problem. It is not going to go away, is it? The number of elderly people will continue to grow; the number of people with learning disabilities will continue, quite rightly, to require more from our services. Councils said that the funding gap was £7 billion last year, but they have also said—the Health and Social Care Committee has addressed this, and other important think-tanks have confirmed it—that if we are to deal with the combination of problems, including the immediate funding gap, the need to address eligibility criteria and bring more people back into the social care system, the challenge to local government finance, and the need for a long-term workforce plan, the gap is probably about £14 billion. That is a big sum of money, and we cannot find it in the existing local government finance system, which cannot cope as it is.
If we carry on as we are, and demand keeps increasing with no improvements to eligibility or workforce pay, there will be a consistent further increase in the pressures on other local government services. There will be bigger cuts to libraries, buses, planning, street cleaning and so on. The public, in the end, will simply not stand for that. I say to the Minister: please, let us just have a bit of long-term thinking and recognise that this is a serious problem that will not go away. Local government funding, as it exists at present, cannot take the strain any longer. We need an alternative source of revenue, we need to keep social care linked in to the rest of local government services, and we need, of course, to develop better contacts with the health service. Money to deal with the problem of people sat in hospital beds when they need to be in social care is welcome, but all that is short-term thinking.
I say to the Minister—and, to be non-partisan, to the Labour Front Benchers—where is our plan for long-term care? Where is our recognition of the funding needs? How will we bring about change? Could we, as the Joint Committee said, just possibly get a bit of cross-party thinking on this for the future? Whatever solution we come up with, we need one that will work for the long term, not just for half a Parliament or for one Parliament.
Damian Green (Ashford) (Con)
May I start by saying how delightful it is to see you back in your proper place, Madam Deputy Speaker? You are very welcome back.
I congratulate the hon. Member for Sheffield South East (Mr Betts) not only on instigating the debate but on much of what he said. He said that he wished to speak in a non-partisan way, and he approaches the subject as the Chair of the Select Committee, while I approach it as the chair of the all-party parliamentary group on adult social care. I found myself nodding in agreement with significant amounts of what he said, particularly the point about the need for long-term thinking and for a quite radical change in the way that we fund adult social care.
That is not just agreed across the House now, but has been for some decades. The hon. Gentleman went as far back as Gordon Brown. I can go back further: I have identified Tony Blair talking to the Labour conference in the 1990s, saying that social care was one of the big issues that he wanted to address in government. Here we are, a quarter of a century later, and we have got through it with a series of short-term efforts and sticking plasters. Long-term plans have been produced and promised but none of them has ever been put into policy. Throughout that quarter of a century of debate, the one thing that has been agreed is that the social care sector needs long-term funding.
The current Prime Minister and Chancellor have understood the importance of a long-term strategy and funding base for the sustainability of adult social care. Indeed, as the hon. Member for Sheffield South East said, the Chancellor was previously—by happy chance— Chair of the Health and Social Care Committee, and that Committee produced a number of reports setting out the need for an additional £7 billion a year for social care. I note that the hon. Gentleman has just doubled that to £14 billion.
I am sure that the figure will rise, not fall; we have only to look at the demographics of the over-65s. Regardless of the rising number of working-age people who require social care of one form or another, if the same sort of percentage of over-65s end up requiring care, the bill will go up by something like 80% over the next 15 years. It is certainly true that demands on the social care budget will rise rather than fall in the coming years.
Mr Betts
Figures are bandied around, but I think that the figure is somewhere between £7 billion and £14 billion. It depends—the right hon. Gentleman is addressing this point properly—on whether we include the rise in demand, the need to have a real review of the workforce and pay, and the eligibility criteria. That is the way in which costs have been dampened in the past. We really need to revisit that whole issue.
Damian Green
I agree; indeed, I will mention workforce later.
The Government have, of course, responded to this issue in successive years, and have found extra central Government funds to pay local government, so we have proceeded from year to year, and although the system has been fragile, it has continued to operate. Of course, the background conditions are getting increasingly difficult. Inflation has an impact on social care providers. A cost of living survey done by social care provider MHA found that 94% of its community schemes had heard members or residents express concerns about the rising costs of living, and 49% of respondents said that the increased costs of transport specifically were a significant issue among their members. There is a danger that rising energy costs will significantly reduce the number of available services and have an immediate impact on discharge from the NHS into the community.
The Association of Directors of Adult Social Services has reported that nearly half of all directors of social care services are not sure that unpaid carers will be able to cope financially with the cost of living crisis, which could lead to further increased demand on paid-for social care services.
Sir Greg Knight (East Yorkshire) (Con)
My right hon. Friend is making an excellent speech. Does he agree that we still grossly undervalue carers?
Damian Green
My only caveat is that my right hon. Friend says “we”. In the community, we do not.
Damian Green
Publicly, as a country, we may well do so. They are a hidden army of people acting well, purely out of generous motives and the desire to help loved ones, which is natural. They do not get enough reward and praise from the general public, even though many of those people are the best members of the general public.
There are other specific measures that the Government could take. I would hope that following April, adult social care providers could be defined as a vulnerable sector as part of the energy bill relief scheme; I think that would be of significant help. The County Councils Network has estimated that with inflation, it could cost councils £3.7 billion extra to keep social care services running. If that figure is anything like accurate, the quality of care will decrease if those providers are not defined as a vulnerable sector.
I will now move on to the central point of the debate, which is funding. The hon. Member for Sheffield South East has very eloquently made the case for what we all know to be true: adult social care is a huge strain. The way in which we currently fund it is something that local councils find unsustainable, and therefore, the system is now kept going through repeated one-off injections of central Government cash. That in itself is not sustainable as a system. Some years ago, I suggested an alternative way of getting the extra money we all need into the system. I will return to that proposal now, because if we step back, the problem is that social care—especially for the elderly, perhaps—is too opaque for those trying to understand it, with no apparent logic as to which conditions receive free NHS treatment and which do not. Moving directly on to the financial point, it is also unfair not to reward a lifetime of prudence. Those who have saved feel that their savings will simply disappear, while those who have not saved receive the same level of care.
There is also the fact—which is not often discussed—that funding social care out of council tax means that local authorities are reluctant to allow too many care homes, or indeed retirement housing, to be built, because they do not want an increasingly elderly population. The ageing population means that something like 50% of some councils’ spending already goes on social care. As the hon. Member for Sheffield South East said, that figure is projected to rise to 60%, and given the demographic trends that I have already mentioned, my fear is that some higher-tier authorities that are funding social care will end up as basically social care providers with a few libraries and a bit of money to spend on potholes, and not much else. A lot of essential council services will be swallowed up by the need for social care, as well as the fact that the problems in social care put extra pressure on the NHS.
We need a radical change to the system in order to meet five objectives. The first is to provide enough money to cope with the increasingly ageing population. The second is fairness across generations, so that today’s working-age taxpayers are not asked to pay for both their own care in the future and the care of the generation above them today. The third is fairness among individuals, ensuring that no one has to sell their own home—has to lose all their assets to pay for care—and ending the dementia lottery that the hon. Member for Sheffield South East mentioned, where one condition is treated on the NHS and another is not. The fourth is increasing the supply of care beds and retirement housing. My fifth point is perhaps slightly ambitious: in an ideal world, we should secure cross-party consensus, with a lot of consultation before we move to a new system, but with the people moving to that system having confidence that Governments of any stripe will keep it going.
The model I take, because we can see it more or less working, is the pension system. The basic state pension has been increased significantly in recent years, taking many pensioners out of poverty, but at the same time, most people save additionally through their working years to provide comfort and security in old age. Auto-enrolment in pensions has been a great cross-party success story, encouraging millions more people to save towards their own security in old age; for an individual who starts saving in their early 20s, the benefits will not come for decades, but they will be huge when they arrive.
Similarly, just as the basic state pension has been improved in recent years, I think we should offer a universal care entitlement, offering a better level of care—both homecare and residential care. For those who need residential care, that would cover the core residential costs. The needs would be assessed locally, but the money would come from central Government, which would take away the pressure on local councils. The state element of that funding should come centrally, rather than locally. Will that involve extra money? Of course it will, but given the annual injections of extra money that the Government put into the system, they have already implicitly admitted that it needs much extra money, so I think this is a necessary increase in public spending. I accept all the pressures and controversies that it will cause, but it seems unavoidable to me.
On top of that, we need to find an acceptable way to allow those with the capacity to improve their own provision to do so. I suggest we should create what I call the care supplement: a new form of insurance designed specifically to fund more expensive care costs in old age, just like the private pension system that tops up the state pensions of millions of people. It would allow people to buy insurance at the level they can afford in order to provide peace of mind. I do not think that the care supplement should be compulsory, as indeed auto-enrolment for pensions is not compulsory, so we would not get into the slightly sterile debate about death taxes and dementia taxes, phrases that both of the main parties have thrown at each other over the years.
People could save for that insurance over many years through their working life, or they could make a one-off payment—possibly using something like equity release from a part of their house value—at a suitable time in their life. I will pause on that point, because too much of the social care debate has devolved into questions about home ownership and whether a person has to sell their home. Under a mass insurance system, nobody would have to lose all of their assets or sell their home; a sliver of the money that is now in free equity in housing owned by the over-65s would cope with this challenge. There is £1.7 trillion in free equity in housing owned by the over-65s, and if a very small percentage of that money were applied to insurance for social care, it would mean that people had peace of mind in old age.
I have been told by successive Ministers that that system would be too complicated, and that we cannot set up an insurance system. All I say in response is this: of course, setting up a new system is complicated and difficult, but we know that the current system is not working. If we carry on doing the same thing, the system will continue to be frail and rickety for years—possibly generations—to come, which is not acceptable. We have to do something radically different. If somebody can come up with a better way of getting some of that wealth to pay for social care, fine, but we have to try something radical.
Funding is one key issue, but since the debate is about adult social care, I will identify four areas in which we need new thinking if we are going to fix social care. The first is the workforce, which has already been mentioned. It needs to be bigger—bigger by more than 100,000—and to achieve that, it needs to be better paid and have a higher status. I would like nurses working in the care system to be on the same Agenda for Change pay scales as those in the NHS, otherwise they will keep moving from the care system to the NHS.
The second area is the voice of care within the new integrated care boards. That change represents a chance to improve the integration of the health and care systems without creating another massive bureaucracy, but I slightly fear that the ICB system is settling down with the voice of care providers not being loud enough at the table. Local authorities are clearly a key player in the system, but so are other providers, and their voice needs to be heard.
My third point is about the use of technology, not only for sharing information between different parts of the system, but for giving those in receipt of care more control over their daily life. We are not exploiting the range of available technology anything like enough to do that and, if we get it right, the prize is that more people will be able to stay in their own home for longer. That is better for them, most importantly, but it is also better for the taxpayer, so it ought to be a high priority. It is particularly important for people living with dementia.
The fourth area is an extension of that notion of people staying in their own homes for longer through the provision of housing. As it happens, in one of the Minister’s previous incarnations, I spoke to him about this issue. We are failing to build anything like enough supported housing for older people, particularly in retirement villages. Taken together, the last two measures I mentioned—technology and the provision of suitable housing—would mean that many people were able to stay in their own home for longer. As I say, that is a double win: it is better for the taxpayer, but most importantly, it is better for people as well. Most people want to live in their own home for as long as they can.
My original idea for a universal care entitlement accompanied by a care supplement would take the burden of social care funding away from local authorities, which is good, and, more importantly, offer certainty and security for the increasing numbers who will need social care in old age. No one would have to sell their house and see their inheritance disappear, everyone would have the chance of receiving better care and fewer people would be left unnecessarily in hospital beds as they wait for social care to be available. I am conscious that none of this is easy and that it will take political courage and possibly political consensus to achieve, but it is absolutely necessary if we are to provide peace of mind and security to frail, elderly people who richly deserve it. I commend these ideas to the Minister.
Helen Morgan (North Shropshire) (LD)
It is lovely to see you back in the Chair, Madam Deputy Speaker. I thank the hon. Member for Sheffield South East (Mr Betts) and the right hon. Member for Ashford (Damian Green) for their excellent speeches. I draw the House’s attention to the fact that I am a vice-president of the Local Government Association.
When the Government announced their local government funding settlement for the upcoming year and the additional £2.3 billion in grant funding at the autumn statement designated for social care, I welcomed that additional funding, despite concerns that much of the rest of the money will come from increased council tax. We are passing the buck from Government to local councils and, ultimately, as the hon. Member for Sheffield South East outlined eloquently, to local taxpayers who may not immediately see the benefit of the tax they are paying.
That funding will plug in the short term the gap in budgets caused by inflationary pressure, but we need to be mindful that 542,000 people are already waiting for care package assessments or direct payments and there are thousands of vacancies in England, according to the Association of Directors of Adult Social Services. The County Councils Network warns that councils and care providers are facing a perfect storm, as I am sure we are all aware, of rising demand, fewer care home beds, chronic staff shortages and acute inflationary pressures.
Shropshire is certainly no exception to that scenario. My meetings with local care providers have consistently shown that the sector is becoming fundamentally unstable, with some providers left facing a choice between losing money, or handing their contracts back to the council and restricting themselves to private work. We should acknowledge that social care is becoming a two-tier sector, where people who can afford a large amount of care in their home every day receive a very good service from skilled and caring workers who come and attend them, but those who are left with only a short visit in their own home see a much worse situation. I have seen that first-hand on an ambulance shift. It is heartbreaking to see people whose carers have popped in on a rushed schedule. They clearly care and have written everything down in the book—in one case, they had called the ambulance—but they do not have time to ensure that those individuals are living in the dignity they deserve. We need to ensure that that variation and those dual standards are addressed in the solutions we propose.
We have also seen that a shortage of care options is a factor in the acute emergency department and ambulance response crisis that Shropshire has faced, because people who are unable to be discharged home are restricting the patient flow through hospitals and ultimately stopping people coming in through the front door.
Today, I would like to raise in particular the challenges faced in the long-term learning disability and autism sector. In this sector, where people with learning disabilities need long-term care, the providers often do not have private clients from whom they can cross-subsidise their council-funded packages. My attention was drawn to that just before Christmas when I was alerted to the fact that three individuals in my consistency, who have lived in a care home together and been cared for by the same care home manager for more than 20 years, faced being split up and rehomed just three weeks before Christmas. Worse than that, because their levels of need were high and the care in North Shropshire met this need, they had come from across the United Kingdom and were funded by different councils. If their care home closes because of cost pressure, they will most likely be split from each other. As I am sure we can all imagine, the impact on those individuals would be extremely severe. I was grateful in this case that their provider was able to reassess their situation and keep them together in the same location, but the funding in this sector is so precarious that there is no guarantee that will be maintained.
As I understand it, the fair cost of care exercise excluded many social care services for people with learning disabilities, autism or severe mental health problems. In learning disability and autism services, a recent survey showed that 71% of providers have handed back a contract, declined to deliver a service or considered doing so in the past 12 months. Some 83% are subsidising services as charitable organisations that should be paid for in full by the state. We can all recognise that is fundamentally unsustainable, and I urge the Minister to consider some of the excellent suggestions from colleagues to stabilise this growing sector caring for our most vulnerable people.
Part of the cause of the instability across the whole sector is the fact that rising minimum wage levels have not been matched by funding from central Government to local councils, and therefore from those councils on to the providers. The national living wage increased by 6.6% from 1 April 2022, and it will go up by a further 9.7% from 1 April 2023. Clearly, that is necessary to deal with the cost of living crisis, and I am not here to begrudge care workers that increase. The staff in the sector are providing caring, highly skilled support, and they deserve to be recognised with a fair pay packet for the work they do.
In rural parts of Britain, such as North Shropshire, home care and community-based services are also seeing pressure from high fuel costs, and the council funding they receive does not take into account either the additional fuel they use travelling around such a large area, or the additional dead time there is between visits to people in rural places. In October 2022, Shropshire Partners in Care, an organisation of care providers in Shropshire, conducted a survey of its members, in which only 18% of respondents said that they felt the fees provided by the council covered their costs on a weekly basis. More than half confirmed that they have reduced the number of council-funded packages or places they are willing to accept.
When I meet care providers in my constituency and carers at work when I am on the doorstep, I am struck by their passion for providing high-quality care for their clients, but I have also been struck by the distress that the cost and recruitment pressures are placing on providers, because they are affecting the quality of service they deliver. The problem is nationwide, too. A Liberal Democrat councillor and friend in Cambridgeshire told me they are seeing an urgent crisis in adult social care there, too. They are facing an estimated 40% projected rise in funding for the elderly, but they have not got the Government funding to match, so they are looking at a £23 million funding gap going forward. They have nursing homes with 50% vacancy rates at peak points during the winter.
I urge the Minister to commit to looking at the long-term settlement for councils, because these costs, as colleagues have already described in great detail, will only increase. We need to ensure that we are fully funding the cost increases for care providers, so that people can receive the care they need and deserve, whether in a care home or, ideally, in their own home. The settlement also needs to take rurality into account and reflect the additional costs incurred when carers are travelling such long distances between homes. It is critical that councils have the flexibility to spend the funding they have been allocated in the most appropriate way for their own area and the requirements of their local demographic.
The Minister will be aware that the Liberal Democrats have called for a fully funded carers minimum wage set at least £2 above the national average, and paid for by a tax on online gambling platforms, to address the recruitment and retention challenges that are knocking into other areas of social and NHS care. Our increased wage would be centrally funded and it would ease the pressures on councils to find savings from elsewhere to meet their social care needs. The Care Quality Commission’s 2022 state of care report stated that
“our health and care system is in gridlock and this is clearly having a huge negative impact on people’s experiences of care.”
It went on to say:
“At the heart of these problems are staff shortages and struggles to recruit and retain staff right across health and care.”
I urge the Minister to consider the points that we have raised, to consider the crucial nature of ensuring that care workers are paid fairly so that they can be recruited and retained, and to consider that whatever the plan is going forwards, it needs to ensure that councils have certainty about their future funding. I urge him to take note of the pressures and to work with his Treasury colleagues to address some of the huge challenges that we have outlined today.
Selaine Saxby (North Devon) (Con)
It is a pleasure to see you back in the Chair on International Women’s Day, Madam Deputy Speaker. It is also a pleasure to follow the hon. Member for North Shropshire (Helen Morgan), whose constituency reflects mine in many ways. I will bring some colour from a constituency perspective to many of the issues and challenges that she highlighted around providing social care.
Devon is a prism of the future, because it has an elderly population that is only getting older. If anyone wants to see what the rest of the country will look like in 20 or 30 years, they should come to Devon. Similarly, if any of the great ideas coming out of this debate can be trialled or tested, I recommend Devon to the Minister as a great place to come. We are already on the journey of our county council frantically trying to balance its budget. Some 25% of the budget is spent on adult social care, and that amount has increased by 23%, adjusting for inflation, in the last decade alone.
As the hon. Member for North Shropshire mentioned, rurality is a huge factor. North Devon is remote, rural and coastal, so the distances involved in providing adult social care are monumental. The dramatic rise in energy costs has had a huge impact on social care providers’ ability to deliver the same service, and the increase in the council’s budget, unfortunately, does not fully reflect that.
Rurality also has an impact on the manner in which care is delivered in those communities, because of the distance that individual teams have to travel between daily stop-offs. That is overlaid with the pressures being placed on the hospital, which mean that some carers are having to make multiple visits a day—perhaps three—to one family, where they might previously have made one or two. That is escalating into a snowball effect of costs rising far higher than is reflected by the council.
I am now being contacted by providers of social care who are concerned about what is happening and their ability to continue to provide the care. One innovative care provider pays its care workers on a shift basis to reflect the distances travelled and the amount of time that care workers are not working, as opposed to paying them on a contact time payment methodology. Given the likely decrease in the next budget, however, it is unlikely to be able to continue that, even though offering that great package is how it has been able to train up and retain its fabulous staff team. If someone has to drive between appointments, why should they not be paid for the driving time, if it is the only way to get there?
We need to redesign the scheme for remote rural locations. As the Minister knows from his previous roles, we have a particular housing pressure in North Devon, so a different way of looking at it would be to remunerate a social care worker with accommodation as part of their package. That would enable them to serve that remote rural community without having to spend hours in the car driving between remote rural communities. The Department for Levelling Up, Housing and Communities might not be the right Department to suggest that to, but we cannot keep on pretending that the system is working. We need to find other ways and different solutions, particularly when rurality is being overlaid on the other pressures. At the moment, clients are being transferred away from better-qualified, better-quality care providers because the council budgets will not stretch, which is not right for the individuals involved. It feels fundamentally wrong that that is happening on my doorstep.
In North Devon, we are home to a fabulous hospital, which is the smallest and most rural in mainland Britain. It is not right that there is regularly a queue of ambulances outside it because we cannot discharge out of the back end due to a lack of social care. I have social care providers telling me that they have capacity but the council will not pay their rates to provide it.
As part of this process, I hope that somebody will look at the fair cost of care exercise in Devon, because there is some concern that the data that has been submitted is perhaps not being accepted as the true price of delivering that care. We need to acknowledge the prices involved, because these are humans who we need to look after and care for in our communities. There is also a concern that the cost pressures faced by the council are driving growth in the number of unregulated personal assistants and private carers.
Mr Betts
The hon. Lady is talking about the fair cost of care. I declare an interest as a vice-president of the Local Government Association, where there is a real concern that the money that the Government made available was not based on the detailed assessment that councils had done about the difference between what people pay for their care privately and what councils are paying. If councils suddenly ended up with that extra cost, the Local Government Association’s view is that the amount would be much more than the amount that the Government were putting to one side in their initial reform proposals.
Selaine Saxby
I thank the hon. Gentleman for his intervention; much more work needs to be done in this space.
We need to look for longer-term funding solutions. That is true for social care, but also for potholes, which I will mention while I have the opportunity, as my right hon. Friend the Member for Ashford (Damian Green) did. Part of the reason why some funding settlements do not add up is that when we provide a short-term funding solution, we cannot plan for the long term. I estimate that we are paying twice as much per pothole repair as a result of short-term settlements that stop councils from being able to plan effectively for their workforce, the work and the use of materials. I hope that there will be an opportunity to address some of those problems, because the pressure on budgets is having an impact on all council services, not to mention the individuals and the fantastic care staff involved.
Barbara Keeley (Worsley and Eccles South) (Lab)
I was not going to speak, but I have been drawn by some of the speeches that I have heard to add some comments, particularly on autistic people and people with learning disabilities and their care. One of the worst aspects of the chronic underfunding of adult social care is that it has led to a reliance on inappropriate in-patient care for autistic people and people with learning disabilities, 2,000 of whom are in that situation. The Government seem chronically unable to get that number down; there have been all kinds of targets to reduce it, but it has not happened.
That care is often expensive and far from home. The hon. Member for North Shropshire (Helen Morgan) told us about people in a care home far from their homes, but when the care is in in-patient units, it is often unsuitable. We know from scandals at units such as the Edenfield Centre, most recently, and Winterbourne View—there have been 10 years of scandals in those in-patient units—that they are frequently found to use restraint and seclusion as a punishment.
There have been inquiries and reports into the level of social care funding, such as that chaired by my hon. Friend the Member for Sheffield South East (Mr Betts), who made an excellent speech. The Health and Social Care Committee, of which I was a member, also looked into the issue and made recommendations. The squeeze on local authority funding means that local authorities feel that they have to put the bill on to the NHS—it becomes easier for a local authority to let the NHS pick up the bill for an autistic person or a person with learning disabilities.
Those placements can cost hundreds of thousands of pounds a year—up to £1 million. In one case that we have spent a lot of time talking about in the House, the NHS was funding a placement that cost £1 million a year. Clearly that makes no sense, because the money could go into housing or care for that person, but there does not seem to be any way to passport the money from the NHS, which is shelling it out every year, to the local authorities that would need it if they were to house and provide care for those people.
However, we had a solution years ago. When people were moved from long-term mental health institutions into the community, a dowry went with them from the NHS to the local authority. When I was the vice-chair of social services as a councillor, if we picked up somebody who had been in a long-term mental health institution to move them to the local authority, they came with a dowry that might be as much as £1 million. If a local authority were to buy a property or pay for care for a number of years, that system would work.
I urge the Minister to look at the recommendations made by the Health and Social Care Committee when we looked at this, but also to take account of what the hon. Member for North Shropshire said about how we cannot leave this in an unsatisfactory and precarious situation. It is good that some solution was found in the case she mentioned, but too often people end up in in-patient care and then will be there for the rest of their lives. There are people in these institutions who have been there 10, 20, 25 or 30 years, and it is tragic, because once someone has spent that long in an institution, it is very difficult to find a way back to the community. I wanted to mention that because it has been raised in the debate.
I want to mention one other thing. The right hon. Member for Ashford (Damian Green) and the hon. Member for North Devon (Selaine Saxby) talked about support and recognition for carers, and they are right to do so. We should all think about how we support unpaid carers. However, I want to say that I think the thing that is missing is that we do not have a proper national carers strategy. The last national carers strategy we had in this country was under the last Labour Government, and it came out in 2008. That would solve the problem, which my hon. Friend the Member for Sheffield South East talked about, of there being no respite care breaks for carers. That national carers strategy had a commitment of £255 million specifically to support carers, including £150 million for respite care breaks. We now find that there is no money we can identify or point to that is specifically for respite care breaks. Given the squeeze on local authority funding, it just does not happen.
What this Government have had is a carers action plan, which is a weak document. The last one, which covered 2018 to 2020, had no funding commitments and was very short of ambition. I know that carers organisations very much campaign for us to go back to having a national carers strategy, which in the case of the Labour Government had the commitment of the Prime Minister and each of the Secretaries of State responsible for services used by carers. I think the key thing, as we have heard in this debate—I really stress this point—is that we have to go back to having some money that is kept separately for respite care breaks for carers, otherwise they will be pushed and pushed, and they will not get the support they need.
I just wanted to speak on those two points, Madam Deputy Speaker, and I join everyone else in saying what a pleasure it is to see you back in your place.
Madam Deputy Speaker (Dame Eleanor Laing)
Thank you. I call the shadow Minister.
Sarah Owen (Luton North) (Lab)
Thank you, Madam Deputy Speaker, and may I also welcome you back? It is great to see you in the Chair.
Today we have been allotted time to speak about something the Government seem to do anything possible to avoid, and that is social care. It got barely a look-in in the autumn statement, and there is not much hope for next week’s Budget either. Every generation in this country is being failed by irresponsible, careless Conservative leadership—or, rather, a lack of leadership. Young people are having opportunities snatched from them by this Government. Working people are underpaid and cannot afford to buy their own home or pay the rent. Our older generation, who have toiled for decades, paid their taxes and contributed to our economy, are now being left in the lurch by the state when they need it the most. These are people such as the wonderful WASPI women whom I met outside Parliament today—women such as Josie from Great Yarmouth, Yvonne and Jane, who all told me to tell younger generations of women, “Look after yourself and plan for later life, because the likes of this Government won’t be there when you need them most.”
Our ageing population do not just deserve good social care; they should be entitled to it. It is their right, and in a country with the sixth largest GDP in the world, it is frankly mortifying that they are not afforded it. The social care sector is a problem the Tory Government have not just neglected, but actually made worse in their 13 years of power. There are currently record high levels of staff vacancies in adult social care—a staggering 165,000 vacancies. The existing workforce are burnt out, underpaid and overworked trying to cover the staff shortages. When I worked as a care worker, going into people’s homes to provide some of the most sensitive of support in sometimes less than 20 minutes, I knew the system was broken. Being pressured by managers to prioritise private patients over those who had support from the state, regardless of their need, was the wrong way of doing things then and it is the wrong way of doing things now.
It is worth noting that this debate is taking place on International Women’s Day. Later, we will hear a debate on childcare funding. While it might be a coincidence that these two debates are being held on this day, it is extremely meaningful. Some 80% of the care workforce are female, and that accounts just for the official staff. Under this Conservative Government, 2.3 million more people have given up some or all of their working hours to care for family members, because they cannot access professional support. That point was made eloquently by my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley). The majority of those unpaid carers will be women, once again taking a hit to their careers, their finances and often their own health to provide care when the state has simply stepped back.
It does not have to be this way. As many as one in three hospital beds are currently occupied by patients who are ready for discharge, but who have nowhere to go. I am sure the Minister and his colleagues know as well as we do that these are not hospital beds going spare. Then there are the waiting lists. Many of us here will have a parent, a grandparent or a loved one in need of adult social care, or care for a younger person with disabilities. I wonder how many of us could say they have received the care they needed in a timeframe they are satisfied with.
Recent figures show a shameful trend of delays and let-downs in the social care sector. More than half a million people are waiting for an assessment, a review, the start of a service or a direct payment—half a million people. When will this backlog be dealt with and what are those people having to do in the meantime? I can take a guess at what some of them are having to do. As much as local councils, charities and places of worship try to plug the gaps left by this Government with food banks and warm banks, many pensioners are left shivering in homes, avoiding too much usage of their lights or televisions even, and watching their bills escalate. They are going to the shops to find no eggs and no tomatoes, and still coming back out of pocket. They are doing all this while dealing with their untreated health issues, and they are waiting up to 24 hours for ambulances to arrive in desperate situations.
Those people are wondering when exactly it was that this Government turned their back on them. Perhaps it was in 2022, when the Chancellor made it clear that social care was not a priority, allocating just £2.6 billion in new funds. Maybe it was in 2019, when a Tory party actually quite different from this one—we have gone through quite a few different leaders and Prime Ministers—promised that
“nobody needing care should be forced to sell their home to pay for it”,
while, on their watch, 28,000 people have exhausted their life savings to pay for care. That point was made by the right hon. Member for Ashford (Damian Green). But no, I think the betrayal of our older generation goes much further back than that.
In 2012, the current Chancellor was Health Secretary. He promised a cap on care costs, acknowledging the financial weight crippling individuals and families. The cap was legislated for in 2014, delayed until 2020 and then postponed indefinitely. After 10 years of being strung along, the hundreds of thousands of people needing adult social care were told in the autumn statement that any reforms of social care charges would have to wait until at least 2025. This is a heartbreaking and intensely frustrating situation for people waiting for answers and for security for the future. People are dying while waiting for state social care—150,000 over the last five years to be exact. I repeat: 150,000 people have died waiting for the care they never received. Will the Minister tell us how our constituents can really trust the Government to solve this crisis?
When he was Chair of the Health and Social Care Committee, the Chancellor stated that an annual sum of £7 billion was needed to plug the gaps in social care. One year later, and now in the position of power to allocate the very funding that he demanded for the sector, he pledged £7.5 billion over two years and, as we have established, only a quarter of that is new funding.
As the deliverers of state social care, local government leaders are well placed to judge what is needed. The Local Government Association has calculated that £13 billion is required to address the severity of the pressures facing the social care service. It states:
“An investment of this scale is needed to support our national infrastructure, our economy and our prosperity.”
Does the Minister believe that the Tory-led LGA is wrong about that? The LGA has also been critical of the Government’s model that continues to rely on council tax revenue to pay for social care. Council tax brings in vastly different amounts in different areas, depending on the demographic of residents.
In some areas, particularly rural communities, funds coming in from council tax are heavily outweighed by the demand for social care. As the hon. Member for North Devon (Selaine Saxby) eloquently put it, there are many different barriers to accessing social care—and good care—within rural communities, and that is just one of them. The hon. Member for West Dorset (Chris Loder) also made it clear that that is an issue. In a debate in January, he argued against the funding model, with one third of his constituents aged over 65, compared with a national average of 19%, which presents a huge need for care. He stated that Dorset Council’s spending on adult social care had risen by 15%, but that that was not touching the surface of the problem, and 83% of the council’s income was reliant on council tax.
The problem lies with central Government and the lack of a sustainable funding model. Fortunately, one party has a plan for social care, and we will not be postponing it for years or decades when we are in power. A Labour Government will implement a 10-year plan for investment and reform in social care. We will increase access and prioritise prevention and early intervention with home care. We will present a new deal for care workers that delivers fair pay, training and working conditions to recruit staff and—most importantly—retain them. We will ensure that unpaid family carers are no longer overlooked or taken for granted. If the Minister can present anything to rival that, I would genuinely love to hear it. As a former care worker, and someone whose grandparents have wonderful carers, I would love to say that we could put politics aside and come to a solution for the good of our country, but I also question the likelihood of that, given the 13 years of failure that we have seen from this Government.
I have mentioned some shocking figures, but I want to make it clear that social care is not about numbers—it is about people. It is about people in desperate need of care, who are often towards the end of life. It is about young disabled people, and families when they are at their most vulnerable. It is about the people providing that care through long hours, hard graft and low pay. Our nation’s older generation depends on them, and so will we when our time comes. I hope for everyone’s sake that they will still be there, and that this Government will not be.
The Parliamentary Under-Secretary of State for Levelling Up, Housing and Communities (Lee Rowley)
I add my voice to all those who have welcomed you back to the Chair in recent days, Madam Deputy Speaker.
I thank right hon. and hon. Members who have spoken in this debate. It has been a good debate that has highlighted some of the challenges, and demonstrated some of the opportunities in this area. I am particularly grateful to my near neighbour and Chair of the Levelling Up, Housing and Communities Committee, the hon. Member for Sheffield South East (Mr Betts). We do not agree on everything, but he had a long and illustrious history in local government before he joined this place, and since then he has taken a significant interest in this subject. I am grateful to him for introducing the debate in such an even-handed manner.
As all those who have spoken today have indicated, this is an important area of policy for a variety of reasons. That is why there is such close working between the Department for Levelling Up, Housing and Communities and the Department of Health and Social Care, given the importance of the issue, the need to get it right, and the need to continue to make progress on some of the challenges that have been highlighted. We have also worked closely to ensure some of the achievements that have come forward in recent years. As hon. Members will know, policy is largely within the Department of Health and Social Care and the funding process, via the local government finance settlement, is within the Department for Levelling Up, Housing and Communities.
I will try to answer the questions as best I can on all the elements that have been raised today. Colleagues raised a substantial number of points that fall into three broad buckets: first, where we are; secondly, where we are going; and thirdly, what we do about the long term. I will take those three points in turn.
First, there is no disagreement across the House that there are challenges, and that there have been difficulties on both a macro level and across government and society as a whole. There are also challenges within adult social care. More broadly, over the past 20 years, under Governments of all parties, we have seen changing demographics. It is great that more people are living longer, but that creates challenges for whoever is on the Treasury Bench to ensure that the Government support people to the extent that they can. There is often greater acuity with individuals in the system, and more have multiple conditions. More broadly, in recent years and despite valiant attempts by the hon. Member for Luton North (Sarah Owen) to gloss over them, we have received the challenges of inflation, of external events and of covid, all of which have created issues across the Government. A mature debate will recognise and acknowledge those challenges, and seek to build on them and resolve them over time.
The hon. Member for Sheffield South East is correct to say that funding has been much questioned over the past 13 years, and we will all have different views on that. The issue has been much discussed since 2010, just as the reasons behind decisions that were taken between 2010 and now have been much discussed. I will not detain the House by repeating those reasons, other than to say that we know them, and that they are at least anchored in a set of decisions that were taken before 2010. It is also important to acknowledge—I hope hon. Members will do this—that significant additional funding has gone in and is going in over the remainder of the spending review period, with £2 billion of additional grants in 2023-24, and nearly £1.5 billion of additional funding in 2024-25. Money is not everything, but ultimately there is a recognition in all parts of the House that there are challenges with adult social care, and more money has gone in.
The hon. Gentleman also talked about the way we fund. Although I accept challenges from right hon. and hon. Members about the right balance, I hope we can agree within our discourse that it is reasonable and proportionate for us to have both funding provided centrally and an element of local funding, not least so that there is linkage between how organisations and local councils decide to spend that money in the locality and how they raise it. As I say, I accept that there are different views about what the proportions should be, but I hope that future discussion of this issue acknowledges the reality and appropriateness of that balance.
Although I am trying not to be too political, it is important to note that some of the challenges have been in place over recent years because there has been a challenge with Government funding over the course of 13 years. We have been trying to keep taxes down for people when we are able to do so. It is important to note that council tax more than doubled under the last Labour Government, and we have spent a significant amount of time and effort in the local government system since 2010 making sure that increases are as low as they can be.
Barbara Keeley
The Minister is talking about the balance between funding being found locally and funding from central Government grant. The issue I have outlined is that it would be unreasonable for a local authority to have to find something like £1 million extra. I have talked about placements for people with learning disabilities or autistic people that can cost up to that. That cost is being borne by the NHS, yet it could be much lower if the person had suitable housing found for them in the community. It is not reasonable to expect a local authority suddenly to find a large amount of money if a case comes up. Together with colleagues from the Department of Health and Social Care, will the Minister look at the idea of a dowry that I put forward, so that people do not have to spend 10, 20 or 30 years in horrible NHS institutions that are often far from home and unsuitable? This is just a logistical problem about where the money is, and it seems that of all the problems we could solve, this is one we should be doing something about.
Lee Rowley
I am grateful to the hon. Lady for her intervention. I will come to her points in a moment.
I acknowledge the point that my hon. Friend the Member for North Devon (Selaine Saxby) made about rurality, which is one reason why it is important that there is a balanced understanding that some funding is raised locally. Different parts of the country will have different requirements, pressures and challenges, which, in many parts of the country, will include rurality. I accept that that creates an issue in certain places. From a local government perspective, rather than an adult social care perspective, we have tried to acknowledge that, at least in part, in the local government finance settlement through the rural services delivery grant. I am always happy to look at that and to talk to my colleagues in more detail, as we prepare for funding settlements in future years.
Selaine Saxby
Does my hon. Friend acknowledge that in massive counties such as Devon, outside the urban south, the very rural hinterland causes variance from the average, and that top-tier authorities should have much more leverage to offer settlements with a far greater differential between rural and urban areas?
Lee Rowley
I certainly acknowledge that there are differences in individual circumstances between rural areas, urban areas, and suburban and near-rural areas, one of which I have the privilege to represent in Derbyshire. The finance settlement seeks to acknowledge that to some extent. As I will come to in a moment, we are also introducing Oflog—the office for local government—which will seek to understand how councils spend the money they receive or raise, so that we can understand the differences that occur around the country and also how people choose to make decisions arising from those differences.
Let me come to the second point, which is where we are going.
Lee Rowley
If I may make a little more progress, I will happily give way to the hon. Gentleman.
I recognise the points that have been made about reform. I note that the hon. Gentleman, my right hon. Friend the Member for Ashford (Damian Green) and others highlighted the importance of looking at how we can continue to improve adult social care in the round and over time, and I pay tribute to my right hon. Friend for his work in the all-party parliamentary group on adult social care in that regard. I also note the broader questions of what we do over the long term, over many years and decades, and some of the issues that the hon. Member for Worsley and Eccles South (Barbara Keeley) highlighted, and also the intervention from my right hon. Friend the Member for East Yorkshire (Sir Greg Knight) about the importance of carers, which I absolutely acknowledge. I will certainly pass back to my colleagues in the Department of Health and Social Care all the policy points, which absolutely have been heard today.
Both my right hon. Friend the Member for Ashford and the hon. Member for Sheffield South East highlighted alternatives, and mentioned Japan and supplements. Decisions about how best to fund the system are long-standing and challenging, and there are always alternatives; I hope it will be recognised that the Government have tried to resolve some of the issues through changes and proposed reforms over the last couple of years, even if they are later than originally intended. There is acute difficulty and challenge in reforming this area, and successive Governments of different colours have been unable to do what many people would like to happen, yet we are determined as a Government to get it right. I hope we have demonstrated progress—both in the short term through further amounts of funding, and through the reforms we proposed a couple of years ago—and we will continue to try to do that.
Mr Betts
I thank the Minister for giving way; his further comments were quite helpful because they lead on to the intervention I was going to make, which comes back to local funding for social care. The joint report by the two Select Committees in 2018 said:
“There should be a continuation for the foreseeable future of the existing local government revenue streams.”
That was accepted, but we went on to say, very clearly, that a new source of funding is needed for social care to recognise the gaps that exist. Does the Minister accept in principle that the Government must come up with a new, discrete source of funding for social care? The Government sort of got there two years ago, then backed off. Are they going to come back to that at some point?
Lee Rowley
As I think the hon. Gentleman is aware, substantial additional funding has gone into the system. I am always happy to discuss the best way that that should be structured—obviously that is a multi-departmental discussion—but I hope there is an acknowledgement that additional funding has gone into the system and continues to go in. The additional information given in our announcements about the remainder of the spending review, over the coming financial year and the year after, demonstrates our commitment to do that. We hope that will have a positive impact on the challenges that have been articulated.
Finally, I want to talk about the long term, which hon. Members from across the House raised in their speeches. We acknowledge that there is a desire, and it is important to try to plan for the long term. We will bring forward a plan for adult social care reform in the spring. I hope that will answer some of the questions that hon. and right hon. Members have raised and assuage some of their concerns locally. To answer the challenge from the hon. Member for North Shropshire (Helen Morgan) about a long-term settlement for councils, while some of the long-term nature of that is debatable, I hope that the broader policy statement, which the Government announced several weeks ago with the local government finance settlement, demonstrates our intent to move forward with a longer-term understanding of what councils can expect to receive from Government, where we are able to do that. As I have highlighted, in the long term we are also seeking to introduce new elements to government, such as the office for local government, which hopefully will provide information not just about what is happening, but information that explains in more detail how local government is spending that money.
Lee Rowley
I have detained the House, but I will be happy to give way briefly.
Helen Morgan
I am grateful to the Minister. The point about long-term funding is so important. Until a couple of weeks ago, care providers in Shropshire did not know by how much their rates would increase in the new financial year, and they were considering handing their contracts back. It would have cost the council a fortune just to find someone who was willing to fulfil some of those care packages. Councils need long-term funding for their own financial stability and to find care packages at an achievable cost.
Lee Rowley
I am happy to confirm that the Government are trying, where we are able, to offer greater visibility of what is coming and greater long-term understanding. We will continue to try to do that across the local government finance settlement, and I hope this policy statement is an indication of that.
Sarah Owen
I appreciate the Minister’s generosity in giving way, and I completely agree on the kind of long-term futures that we talking about for local government, yet we are 23 days away from local authorities setting their budgets and they have still had no indication about their public health grants. If we are going to treat local authorities with respect on healthcare, surely they should be given that well in advance.
Lee Rowley
I know that my colleagues across Government will be working hard to get the final elements of the settlement out as soon as possible, but I hope the hon. Lady will acknowledge that, on the basis of my conversations with local government over the past few weeks, there is a recognition that the settlement has provided a good level of funds, that it will be moving in a positive direction and that it provides the stability and greater certainty that local government has requested and that we have responded to as a Government.
To conclude, I again thank the hon. Member for Sheffield South East for instigating and opening this debate. I also thank everybody outside this place who supports adult social care. It is an extraordinarily important part of local government and the state’s activities in general. As has been outlined in this debate, we need to support the most vulnerable and those in need, irrespective of age or condition. Through the changes that are coming in the new financial year, we are trying to provide additional funds, support and taxpayer subsidy to do that, and to ensure that local government can continue to build and improve for the long term in such an important policy area.
Mr Betts
Madam Deputy Speaker, you came into the Chair as I was halfway through, so let me, too, welcome you back.
This has been a good debate. Whether it has taken us forward, only time will tell. The challenges are there and hon. Members, certainly the co-chair of the all-party group on adult social care, the right hon. Member for Ashford (Damian Green), expressed it. We spoke in very similar terms on very similar issues. The concerns are there. As was said in the debate, it is about individuals: individuals getting care that is often not to the standard they need; individuals not getting care at all because the eligibility criteria have changed; people sitting in hospital beds for days on end because the care is not available to them. In the end, this is a very human issue we are dealing with. We are dealing with a workforce under enormous strain and pressure, not properly paid and sometimes not properly trained, with far too much expected of them. Councils are struggling to do their best to represent their local community. Councils across the board of all political persuasions are having to make impossible choices to deal with social care and the people who need it, as against having to sweep the streets and run bus services that are vital to their communities. This is an issue that needs to be addressed.
I come back to what I said in my last intervention on the Minister. We cannot carry on believing that the existing local government finance system, with occasional top-ups from Government on an ad hoc basis every year or so, will sustain adult social care for the longer term or even the medium term. We must reach some sort of agreement on a way forward that brings an additional funding stream into local government to take the strain off the rest of local government finances, put social care on a proper footing, increase the eligibility criteria, get a long-term plan for the workforce, and ensure, ultimately, that the people who need social care get it and get it to a proper and decent standard.
Question deferred (Standing Order No. 54).
Department for Education
Childcare and Early Years
(1 year, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Robin Walker (Worcester) (Con)
It is great to see you back in your place, Madam Deputy Speaker. Both you and the late Baroness Boothroyd have demonstrated amply, on International Women’s Day, that a woman’s place is in the Chamber and preferably in the Chair of the Chamber.
I am very grateful to the Backbench Business Committee for approving this very important and timely debate, and to all colleagues across all parties and across the House who supported my bid for it. I would also like to pass on my thanks to the Liaison Committee, under whose auspices these estimates day debates take place. I pay tribute to the work that the Petitions Committee has done in this area. I have come hot foot to this Chamber from a meeting of the Petitions Committee, as has my hon. Friend the Member for Winchester (Steve Brine) and the all-party parliamentary group for childcare and early education which he chairs.
The departmental estimates briefing from the House of Commons Library shows education as the second-biggest winner after health in absolute terms when it comes to changes in day-to-day spending—the so-called resource departmental expenditure limits line in estimates—and a minor loser on capital DEL. The welcome increase in the former, however, is dominated by the impact of the revaluation of the student loan book.
As a former schools Minister, I cannot begrudge the fact that the largest proportion of the £3.9 billion increase in the education resource budget is going to schools, and I am in no doubt that the extra funding of £2 billion in each year of the next two years announced in the spending review is needed in the schools system. Nor do I in any way regret that the second-biggest winner in the education space is high needs. As we heard on Monday, the Government have overseen a 50% increase in spending on high needs since the 2019 election, which I very much welcome and support.
However, I am concerned. As the House has heard many times, early intervention is money well spent and the case for early intervention, early identification of need and early education is stronger than ever. In that context, it is deeply concerning that the only line in the departmental estimates that is clearly focused on childcare or the early years is a £52 million increase in resource DEL. That increase in spending on the early years is tiny in comparison to the overall increase in the Department’s budget, a rate of increase across the piece of just 1.4% when compared to the same line in the 2022-23 main estimate. That breaks down into an increase in early years funding for schools of £35 million, a rate of increase of just 1% and an increase of £17 million for early years funding through the families budget, a slightly more reassuring 14% annual increase.
Such numbers without context might sound very significant, but the context, as we are often reminded by the Front Bench, is that the Government spent nearly £20 billion on childcare and the early years over the last five years, and are currently spending around £5 billion a year across the various different Government Departments that support it. I do not claim to be an accountant. I do not claim to be the greatest living authority on the departmental estimates process and—pace the Prime Minister—I did not complete an A-level in mathematics, but I do know that an increase of £52 million on a budget of billions is not a big deal. In fact, the House of Commons Library’s very helpful briefing for this debate confirms that the Department for Education’s resource DEL for early years is being increased by just 1.4% from £3,781 million to £3,833 million. At a time when inflation is running at around 10%—even if we hit the Prime Minister’s laudable ambition of halving it we will be running above 5%—that does not feel like anything close to a real-terms increase.
In evidence to the Education Committee, the Institute for Fiscal Studies highlighted the problem. It submitted written evidence in November 2022, headed:
“Funding for the early years is likely to fall by 8% up to 2024 as a result of faster-than-expected cost rises”.
It set out that
“The early years sector in England received a significant uplift to its budget at the last Spending Review in 2021…but higher-than-expected inflation means even that increase will not compensate for rising costs. We estimate that childcare providers’ costs are likely to rise by 9% in total between this year (2022-23) and 2024-25. Judged against these rising costs, total funding for the free entitlement will be 8% lower in real terms in 2024-25 than it is this year.”
Steve Brine (Winchester) (Con)
I welcome my hon. Friend’s speech and I welcome his Select Committee conducting an inquiry into childcare and early education. We can talk about entitlement as much as we like, but if the settings are not there, we have a problem. The private voluntary independent sector is losing numbers. I have seen two closed in my constituency in the past six months. This is a problem. We have a supply side problem. Does he agree that achieving parity on business rates between the PVI sector and the maintained sector where an early years setting is in a school would help significantly with its in-year budget problem?
Mr Walker
My hon. Friend demonstrates his considerable knowledge and expertise in this space, and his all-party parliamentary group has gathered evidence from across the sector. I will come back to that point, because it is one of the many things we could be doing to help.
In fairness to Ministers in the Department, I know very well that they have been doing hand-to-hand combat with the Treasury year in, year out for more investment in every phase of education. In recent years, those battles have borne fruit, particularly for schools and for the high needs pupils in them. I also recall starting this year at the launch of the IFS’s very interesting report into education spending, which confirmed that over the last decade the early years has been the fastest growing area of Government spending in education and, unlike in the schools space where current increases in funding are making up for previous years of real-terms cuts, the early years budget has grown faster than any other phase of education in real terms under the Conservative Government.
By contrast, and before we hear too many speeches on Labour’s proposals for an all-singing, all-dancing £20 billion childcare offer, we should remember that it left a system with a single 15-hour offer and Department for Education spending on childcare and the early years at roughly a third of what it is today. That is the backdrop to the disappointing departmental estimate that underpins the debate.
The House will be aware, and as my hon. Friend the Member for Winchester mentioned, that I started my term as chair of the Education Committee with a call for an inquiry into childcare and the early years. I am very grateful to all the people, across parties, who elected me to that position and to all the members of the Committee who unanimously accepted that call. The inquiry is now well under way. We have heard loud and clear from the nurseries, childminders and the wider early years sector about the challenges they currently face—challenges my hon. Friend alluded to—the pressures they are feeling, and, as the IFS confirmed, the very real inflationary pressures being felt by the sector. We have heard time and again the case for more investment in this crucial sector. Although it is too early for me to pre-empt the findings or recommendations of our inquiry, I believe passionately that there is a strong case for more Government investment in this space.
Margaret Greenwood (Wirral West) (Lab)
The hon. Gentleman is making an interesting speech, and I commend him on his focus on the importance of early years education. Sarah Ronan of the Women’s Budget Group has said:
“Years of chronic underfunding have led to extortionate fees for parents, providers closing down and early years workers leaving the sector because of poor pay.”
The Government are providing insufficient funding to cover the existing 15 to 30 hours, as has been mentioned. The Women’s Budget Group is calling on the Government to address that by increasing investment in childcare by £1.75 billion. Obviously, it is about not only the welfare of children but enabling women to be in the workplace, because without affordable childcare, women cannot be in the workplace. Does the hon. Gentleman agree that it is really important that the Government listen to groups such as the Women’s Budget Group, which has a lot of expertise in this area, and consider this issue further?
Mr Walker
I want the Government to listen to many groups across the whole sector and see the case for investment. I will come later to the different elements of the case for investment, to which the hon. Lady rightly refers.
Childcare affordability is a crucial part of the argument. To date, our inquiry has heard about a perfect storm facing the nurseries and childminding sector, of parents struggling to pay the costs required to make the so-called “free hours” work, of rising employment costs and greater than ever competition for staff, and a high burden of bureaucracy. For the vast majority of providers run by the independent and voluntary sector, there is also the challenge of business rates, as my hon. Friend the Member for Winchester mentioned, which are increasing at an alarming rate, and of having to pay VAT on their investments when neither of those costs is felt by their direct competitors in school-based provision.
The National Day Nurseries Association has published figures that suggest that despite the very welcome increase in funded hours for parents, the Department—perhaps more accurately the Treasury—has knowingly underfunded the free hours so that there is a clear and increasing burden on parents and on settings themselves to cross-subsidise the two-year-old and 15 and 30 hours offers. The Sutton Trust has pointed out that 75% of childcare providers said that funding provided per hour for the 30 hours entitlement did not meet their costs, forcing them to apply charges to better-off families, including extras such as nappies, sunscreen and lunch. They say that that undermines the intention of the 30-hour policy as a free entitlement.
We have heard concerns from parents that the myriad different offers and support systems across early years are confusing, and from providers that the use of “free hours” terminology causes conflict with their customers. The reality is that these are subsidised hours, for which the state bears only a share of the cost burden. We have heard concerning statistics about the underspend in both the Department for Work and Pensions and the Treasury schemes to support childcare, because the need for up-front payments out of net income deter both parents on universal credit and those who should be benefiting from tax-free childcare from using the Government schemes. That is both part of the problem and, in my view, part of the solution. There is money that the Treasury has already approved to support childcare in the early years that is not getting spent. That money needs to be put to work to support the very real needs of parents and children.
That brings me to the fundamental point about the case for investment. The Prime Minister rightly said that education is the closest thing to a magic bullet that we have. Investing in education is a good thing and something that I have dedicated most of my time on the Back Benches to supporting. Early intervention usually pays dividends, and that is especially true of education. Many Members across the House, mostly notably my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), have repeatedly made the case for investment in the first 1,000 days of children’s lives. They have pointed to the strong scientific evidence that investment in this period has more impact on the way minds develop than any other.
The Nuffield Foundation has said that there is a strong case for additional investment in the early years, as a “foundational stage” of early development. It states:
“Given that lifelong inequalities have their roots in early childhood, this would be investment in social and individual well-being in the long term.”
An interesting research summary of “The Lifecycle Benefits of an Influential Early Childhood Program” by the Heckman Equation, states:
“Every dollar spent on high-quality, birth-to-five programs for disadvantaged children delivers a 13% per annum return on investment.”
Others have pointed to the huge productivity gains to be made from providing childcare that supports parents, particularly mothers, to continue in or return to work.
On International Women’s Day we should recognise the substantial benefits of closing the gender pay gap and allowing more women to realise their full potential, focusing not only on participation levels but on the quality of participation in the workforce. According to a PwC report published in March 2021 on women in work:
“There are large economic benefits to increasing the number of women in work.”
It estimated that the UK could gain £48 billion per annum from
“increasing female labour force participation rates to match those of the South West – consistent top regional performer for female participation in the UK index.”
A report by CBI Economics and the Recruitment & Employment Confederation from July 2022 entitled “Overcoming shortages - How to create a sustainable labour market” stated that if unaddressed, labour and skills shortages could see the economy lose £30 billion to £39 billion annually. Gingerbread has said:
“Successive research that we have undertaken pinpoints the cost of childcare as the biggest barrier to single parents in finding and staying in work as well as in progressing in their careers.”
Sometimes, including in the evidence provided to our inquiry, it has been suggested that there is some conflict between the two objectives. In reality, investment in the early years and in childcare should be a win-win. It should be good for the children, who are better stimulated, supported and prepared for education, and better for parents, who know that they can engage in work with confidence, knowing that their children are getting that stimulation in a safe setting that meets their needs. A recent report by the Centre for Progressive Policy think-tank has suggested that the economy stands to gain a staggering £38 billion, or 1% of GDP, if a fully effective childcare system could support more women to continue in careers and reap the benefits of returning to work. Others, such as Onward, have pointed to the clear desire of parents to have access to affordable and flexible childcare, and the benefits of both parents being able to deploy help from the Government effectively.
As Schools Minister, I often heard concerns from primary schools about the challenges of children arriving in schools less school-ready than they had been previously, and the greater range of measures and extra support needed to prepare them for life at school. Having children stimulated by excellent early years provision would address that challenge far more effectively and in a more timely manner than interventions or catch-up funding spent in the school years. In the noble quest of ensuring that more children leave primary school able to read, write and do maths, investment in the early years when they learn basic communication—their letters and numbers—should be a no-brainer.
Laura Barbour of the Sutton Trust told the Select Committee:
“In primary schools, 93% said that they recognised that time spent in an early years setting prior to attending primary school made a significant difference when they arrived in school, particularly for children from more disadvantaged families.”
Steve Brine
My hon. Friend is making such an important point, which is one of the reasons why the all-party group that I lead is called “on childcare and early education.” It is important that we flatten the distinction in taxation terms between early years settings and early years carried out in school. The people who run those settings—I declare an interest because my wife works in one—are early years educators. All too often society does not see them as that. I know that the Minister does, as have all previous Ministers, but all too often the discourse is about just childcare. It is not—it is early education.
Mr Walker
My hon. Friend is absolutely right, and I am glad that he has declared his family connection in that respect. We should all value the contribution of the early years and the people who work in what we might describe as childcare but is early education, early simulation and support of children. The steps that the Princess of Wales has taken to draw attention to the importance of the sector are very welcome.
Dame Andrea Leadsom (South Northamptonshire) (Con)
I have to pick up the term “early educator” because the reality is that most children start nursery when they are about six months to eight months old. It is simply wrong to call it early education—what those tiny babies need is a loving, nurturing environment. To call it early education is just the wrong terminology and sends the wrong message. What they need is love and attention. For babies who come from chaotic homes, very often that is their route to secure secondary attachment to somebody. I find that term very misleading, and I wish that we would not always use it.
Mr Walker
I recognise my right hon. Friend’s point. That is part of the dilemma of covering this as an issue from nought to five. The earliest years are not necessarily about education—certainly not in any formal sense—but about stimulation and support. My argument is that the changes that the right support and the right stimulation unlock in young brains and the progress that it allows children to make pay enormous dividends in the education system further down the road.
Siobhan Baillie (Stroud) (Con)
I absolutely love this important debate. What the country and the sector want is parental choice. Many parents are telling me that they do not have enough options because settings have closed or are too expensive. As my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom) says, very young children are often better placed with their mother or father or with a childminder, nanny or au pair. There should be a range of options, but in recent years the options have steadily declined. Parental choice, underpinned by quality, is exactly what we should be hoping to achieve.
Mr Walker
My hon. Friend has been a great champion for parental choice; I know that she has worked with Onward and others to make the case for it. That is a really important part of the argument, and I look forward to engaging with it as the Education Committee inquiry progresses.
Simon Hoare (North Dorset) (Con)
Does my hon. Friend agree that a beneficial but often overlooked by-product is that people can become better parents as a result of meeting other parents? Being a young parent can be a very scary experience, especially without having had younger siblings. Beyond the benefits for children, it can be very beneficial for parents to share experiences and have conversations with other parents and with the people who run facilities.
Mr Walker
My hon. Friend, on whose Select Committee—the Northern Ireland Affairs Committee—I am happy to serve, is absolutely right. I have learned a huge amount as a result of having children in childcare and early years settings and talking to the brilliant people who look after them. It is absolutely true that the people who work in this space provide that support. I also think that the Government’s family hubs intervention will be very welcome, particularly if there is outreach and support in the community.
When we take into account the stimulation for young minds, the benefits for parents and the impact on schools, the case for investment in early years becomes a win-win-win—and that is not all. We all know about the rising tide of demand for specialist and high needs support; the Minister was very frank about it in her statement on Monday. We all know that the early identification of need is vital to children’s life chances. Picking up challenges such as autism, speech and language difficulties and hearing or visual impairments early in a child’s life enormously increases their chances of managing their condition, getting the right specialist support in place and being able to engage with mainstream education.
If the Treasury ever wants to reduce the high needs deficits that beset our local authority budgets and simultaneously unleash the potential of more young people with special needs, it needs to understand that investment in early years and in the professions that can support, identify and meet needs in the early years is a must. Investment in the early years and childcare should therefore be a win to the power of four. There can be few sectors of the economy in which there is such obvious and compelling payback.
Kit Malthouse (North West Hampshire) (Con)
My hon. Friend is quite right to use the word “investment” in this context. Has he ever come across the Tangelo Park project in the United States, which has fascinated me for many years? A local philanthropist took over a neighbourhood in Florida that was plagued by crime and low achievement—what one would refer to as a rough neighbourhood. He made two offers to the population: he said that he would pay for universal, high-quality pre-school childcare and that anybody who got into college would get it free. Obviously people normally have to pay for college there, so that created an incentive. The project has been going for 20 years and has completely transformed the neighbourhood, which has become prosperous, crime-free and a lovely place to live. If we are interested in regeneration and levelling up across everything we do, investment is about not just the individual child and their family, but the area in which they live and their community’s sense of aspiration and purpose.
Mr Walker
My right hon. Friend makes an excellent point. We had a very interesting debate on the Levelling-up and Regeneration Bill about childcare as an infrastructural issue, which I think reflected those benefits. I agree that we need social entrepreneurs to invest and play a role in this space. The private, voluntary and independent sector, which currently dominates provision, is so vital. It is important for us to work with the sector and support it rather than placing it under the pressures that unfortunately we are seeing today.
This is a debate about departmental estimates, but I am first to recognise that not all spending on childcare and early years comes or needs to come from the Department for Education’s budget. Within that budget, however, we have seen welcome commitments to review and increase the local spending on funded hours. I am proud of this Government’s record of delivering both the targeted two-year-old offer for disadvantaged children and the 30 free hours for some working parents.
Evidence given to the Education Committee makes it all too clear, however, that those welcome steps are coming under real pressure from rising costs. Helen Donohoe of PACEY, the Professional Association for Childcare and Early Years, told us:
“The number of childminders has halved in 20 years. We project that by 2035 we will have only about 1,000 childminders left in the country. That is from 60,000 20 years ago”.
Dr Grenier, a nursery school headteacher, told us that
“roughly 10% of nursery schools have closed in the last 10 years and more are due to close soon.”
Kara Jewell, a nursery director, told us:
“In 2003 when I registered as a childminder our funding rate was £3.02 per hour. It is now set to go to £4.69, so our funding rate has gone up 55.3% in 20 years while the minimum wage has risen by 131.56%.”
Emma Gardner, who is quality manager for early years and childcare at Spring by Action for Children, told us:
“I certainly think that funded places in settings that take funded children will reduce dramatically because it is just not sustainable.”
Much of the potential for real investment in this space comes through the Treasury’s so-called tax-free childcare offer and the Department for Work and Pensions’ substantial contribution through universal credit. However, our Committee has heard that neither is working as effectively as it should, and that both need reform to meet the needs of parents today. The Early Years Alliance has suggested to our Committee that the tax-free childcare policy should be stopped and that the theoretical billions set aside for it should be invested in meeting the full costs of the so-called free hours. We have heard from others that the money could be better invested in extending the scope of the subsidised offers from three and four-year-olds down to one and two-year-olds.
Against that, it is worth bearing in mind that the tax-free childcare offer is currently the only part of the system that offers parents any support for children under two or over four, so cutting it off completely would come at the expense of many who use it. I also think that it is worth exploring the true potential of actual tax-free childcare. We could make it much more attractive for parents by allowing childcare costs to be claimed against taxation for the household, as many European countries do, rather than offering a 20% subsidy on cash placed in an account from post-tax income.
There are other ways for the Treasury to help the sector that I believe are worthy of immediate consideration. It could remove business rates from the PVI sector, which provides approximately 80% of childcare in this country. It could remove the unfair burden of VAT, which holds back investment. I know that such moves would come at a cost and that the Chancellor has a hugely difficult challenge in balancing the books after all the challenges of the pandemic, but I plead that he consider the huge benefit of supporting investment in this space and the enormous upsides of better stimulated children and of more parents returning to work.
If such reforms prove a bridge too far, I hope that the Chancellor will look urgently at the massive increases in rates facing many in the sector. The NDNA told our Committee:
“Business rate property revaluation from April 2023 has seen providers report bill increases of 40-50%”.
I received clear evidence of that last week from a passionate early years advocate in my constituency who has been made an MBE for her services to the sector. She is despairing at the proposed increase of 35% in the rates for her outstanding-rated Worcester provision, which is compounded by the fact that the local funding rate has increased by just 1% for two-year-olds and 5% for three and four-year-olds while the national living wage on which many of her staff are working has increased by 9.2%.
I will conclude my speech not by pre-empting the findings of our Committee’s inquiry further than I have done already, but by quoting directly from my constituent. In a recent letter to me, Alice Bennett MBE—the founder of the Worcester Early Years Centre and the recipient of an honour in recognition of her outstanding work in the early years sector—wrote:
“I appeal to you and your Government once again for urgent reform in this nation’s early years sector. We are facing the most challenging time in decades with settings closing and talented staff leaving in droves…We all know that 90% of a child’s brain development happens before the age of 5. The research and evidence for this is utterly convincing.”
She described investing in the sector as
“morally and ethically the right way forward, thereby ensuring that every child can realise their rights and entitlements to develop their full potential and to thrive and enjoy a meaningful existence in this world. Our sector is indeed very dedicated and hardworking but we cannot continue to work for peanuts and be subject to such punitive taxation. Our lifetime legacies of outstanding and irreplaceable nurseries will be forced to close without some form of sensible revision and financial interaction.”
There is a real case for responding to that call for help.
On International Women’s Day, we should celebrate the enormous contribution to this sector of female entrepreneurs—people who have invested a lifetime of learning and labour in supporting children’s development.
I believe that we have a Prime Minister and a Chancellor who recognise the case for education and early intervention, and I know that we have a Children’s Minister who is passionate about the value of childcare and early education. I am hopeful that next time we debate the departmental estimates, they will have enabled the Department of Education to deliver a sustained uplift in investment in early years, and to build on the Government’s overall record in this regard.
Taiwo Owatemi (Coventry North West) (Lab)
Happy International Women’s Day, Madam Deputy Speaker. It is great to see you back in the Chair.
Last week I visited Georgie Porgies Pre-School in Holbrooks, in my constituency. It provides outstanding care and early years education for more than 60 children at the most important stage of their lives, but because of the Government’s failures, it will soon have to close its doors for good unless something is done. With a gas and electricity bill totalling £1,000—an increase of 100% on last year’s—George Porgies, along with pre-schools and nurseries across the country, is coming to the awful realisation that it will not be able to fulfil its mission: to give children the best possible start in life.
Katie, the owner of Georgie Porgies, pays herself a salary that is below the minimum wage simply to keep her business afloat—a business that provides employment for nine people and vital education for tens of children—but despite this selfless sacrifice, she and her business face financial ruin. To put it simply, the Government are levying a tax on generosity and kindness. Katie faces financial hardship because she cares and is passionate about what she does. She loves her community, and wants to give children the best possible chance in life. If she took the very reasonable decision to step away and find another job, she would no doubt find herself in a much more secure position, but she and thousands like her are not driven by money. They want to make a difference, and because of that, the Government continue to punish people like her.
Let me make it clear to Conservative Members that Katie does not need any business advice on how to make her money stretch or improve efficiencies. What she and everyone in the sector need more than anything is deep-rooted, fundamental change to a broken system. That is the only thing that will keep childcare businesses in every corner of the UK afloat. Childcare costs in the UK are the third most expensive in the world, after those in New Zealand and Switzerland, and still the Government are doing nothing about it. We need to move away from the current model and rethink the system.
The Government talk about wanting growth, but while the cost of childcare continues to be a serious financial burden both for families and for those who provide it, the social infrastructure that allows us to contribute economically is rapidly coming apart at the seams. I speak to many families on the doorstep every week, and the No. 1 issue that comes up—apart from the cost of living crisis—is childcare. Thousands of women in my constituency are facing the impossible choice between staying at home to look after their children and going back to work, which means that many of them are sacrificing hard-won careers.
Let me end by asking the Minister to listen to Katie’s words of desperation:
“Help me keep a business I absolutely love. Help me keep nine people in employment. Help me keep over 60 children in a nursery that is full of love, care, and happiness.”
I do hope that the Minister will have an adequate response for Katie.
Dame Andrea Leadsom (South Northamptonshire) (Con)
May I say what a huge pleasure it is to see you back in the Chair, Madam Deputy Speaker—and what better day to be discussing this topic than International Women’s Day? I wish all the women—and men—in the Chamber a happy International Women’s Day. Is it not wonderful that there are so many of us now? It is indeed wonderful to see so many women in politics, making a contribution and debating these issues. On behalf of all of us, I want to encourage every young woman, of whatever party, who has political interests and ambitions to get stuck in. We will help you. Come and join us; you will be most welcome.
Let me begin by paying tribute to my hon. Friend the Minister, who has been such an advocate for what, as I think everyone in the House knows, I am so passionate about: giving every baby the best start in life. The lovely thing about that is that I am, so far, not alone. Every Member I talk to, in every party, is incredibly supportive, because we all know from bitter experience of constituency cases, from what we have read, and from what we have learned as politicians and in our own lives, how critical it is for every single baby to have a chance of the best start in life.
Let me give the House some statistics. We know from a study conducted by the Early Intervention Foundation in 2016 that the cost to our economy of late intervention is about £17 billion a year. Almost a third of that is the cost of looked-after children. The children who have some of the worst outcomes in the country are those who are removed from their families and taken into care, and it is shocking that so much money is spent on achieving such poor outcomes. Huge parts of that £17 billion are spent on dealing with domestic violence, and young people who are not in employment, training or education and whose life chances have been hampered by their not being given the best start.
My hon. Friend the Member for Worcester (Mr Walker) has already mentioned the work of Professor James Heckman in analysing the rates of return on human capital investment. It says very clearly, “If you do not care about human happiness, just look at the money—follow the money!” A pound, or a dollar in the professor’s case, invested during the antenatal period will pay exponentially more, in terms of the return, to the human potential of the child—and will lower the later cost to society—than a pound, or a dollar, spent further down the line, when that child is already in the realms of youth crime or perhaps mental illness. Financially, prevention is not much kinder but so much cheaper than cure. Across our United Kingdom, and indeed across the world, there is a growing wealth of evidence for that.
I pay tribute to the Princess of Wales for her amazing work through the Royal Foundation Centre for Early Childhood, observing the struggles of parents and the number of parents who do not feel confident about knowing what their baby needs. I have talked to consultant paediatricians as part of my work as the Government’s early years healthy development adviser, and one of them said to me, “I am supposedly an expert in this field, but when my wife and I had our baby, we were like, ‘Aargh! What do we do with this?’” That is the challenge. It is not about the nanny state, or about interfering; this can happen to any us. I had three babies, and by the third time I thought I had it sussed, but my 19-year-old still gives me hell!
When you first have a child, you do think, “What am I supposed to do with this?” You take that beautiful, squeaky new baby home, and once you have got over the stitches and the other horrific unspeakable things that befall women in these circumstances, you find yourself trying to focus on the fact that you have had no sleep, which is an effective torture, is it not, Madam Deputy Speaker? We all know what it is like if we have had no sleep, and your baby, like my first, does not sleep for more than two hours at a time. In the one antenatal class that I just vaguely recalled, I was asked, “What is your 24-hour clock like now?” We all said things like, “Between 11 pm and about 7 am, I am fast asleep.” Then we were asked, “What do you think it will be like once you have had the baby?” We all said, “Well, I don’t really know, actually.”
It is so difficult, having a baby. You can be as rich as Croesus, you can be happily married, you can have all the support and the nannies in the world, you can have maternity nurses, and it is still difficult. Actually, I pay tribute to the Netherlands, where 95% of babies are born at home and you get a free maternity nurse, on the state. I would do that trade any day of the week—hands up those who would not! To have someone who will take the baby off you so that you can get a few hours’ sleep—that is extraordinary. However, I hope I am not freaking out anyone who is thinking of having a baby: it is the most glorious thing we ever do, and I welcome the fact that so many of our colleagues in the House have young children. I was proud as Leader of the Commons to introduce proxy voting for baby leave, because, oh my goodness, we cannot just sit at home and watch everyone voting and hope that our slip is going to be adhered to. We need to continue our lives.
So, for many women, and men, this is the most difficult thing they ever do, but what is so appalling is that we are really not allowed to say that. When I had my first child I was working at Barclays and I had just been appointed senior executive—one of only eight women; it was an absolute badge of honour—and they said, “We will do this appointment if you will come back after 10 weeks.” I know that seems extraordinary. They could not legally do that now, but in those days they could. And I said yes, which was really stupid. In hindsight, why on earth did I say yes? Anyway, there ensued two miscarriages, postnatal depression and awful trauma, and I left. It was not a happy experience. I say that because we are never allowed to say when things are difficult and we are really struggling, but we really want to keep our career. We do want to have it all, and that is understandable, but at the moment we really cannot.
We absolutely have to focus on the incredible investment in the early years. Again, I pay tribute to the Under-Secretary of State for Education, my hon. Friend the Member for East Surrey (Claire Coutinho); to the Prime Minister who, as Chancellor, funded this incredible project; and to the Chancellor, who as a Back Bencher and Chair of the Health and Social Care Committee was absolutely supportive of the best start for life. I also pay tribute to Opposition colleagues. One of my earliest friends in this place was the wonderful Lord Frank Field—if I may use his name since he is no longer an MP—and the even more wonderful, if that is possible, Dame Tessa Jowell, both of whom have been such advocates for giving every baby the best start in life.
What the Government are seeking to do is to provide support. My hon. Friend the Member for North Dorset (Simon Hoare), who is no longer in his place, talked about the importance of early years settings to build families’ capacity to be parents. In those settings, parents can chat to others and ask, “What size nappies are you using? Have you weaned yet? What are you feeding your baby?” We do not get a manual, do we? We should, but we do not. Another thing we do not get, which we should, is an on/off button. Don’t you agree, Madam Deputy Speaker? I am sure Matthew would agree. When Madam Deputy Speaker’s son used to sit in his sitting room opposite mine and play my music in my flat from his Bluetooth, I wanted an on/off button then. He was a bit older.
That is one of the challenges that we have as parents: there is no manual. So how do we get that information? We have the Government’s programme of rolling out family hubs across England. I wish we could roll them out across the UK, and we will be working with our colleagues in the devolved Administrations to make that the case. In Scotland, they have got parenting mental health absolutely sorted but they do not have family hubs. Talking to some colleagues who are Scottish parliamentarians, I know that they would be keen to follow what we are doing here. I think we can learn from each other all around the world. In Chile they have the most wonderful support for new mums that we do not currently have here, but we are starting to roll out the family hubs across England.
Most importantly, we are rolling out the best start for life, which involves six universal services. People who go to a family hub will be able to get antenatal midwifery checks, to chat to a health visitor, to seek support for their mental health issues or those of their partner or any member of their family, or for their relationship with their baby. They will also be able to get breastfeeding support. This is another ridiculous thing: we are all expected to know how to do that, aren’t we? How on earth do you breastfeed a baby? Who knows? Hands up, any of the men? No. We do not get a manual for that either, and actually women need a lot of support. You would not give your five-year-old a two-wheel bicycle and say, “Right, off you go, darling.” You hold the back of the seat until they have got the hang of pedalling. Our breastfeeding rates are among the worst in western Europe and that is because no one gets any help—
Steve Brine
On that point, will my right hon. Friend take an unlikely intervention?
Dame Andrea Leadsom
My colleague is going to tell us how to breastfeed, ladies!
Steve Brine
I have never name-checked them in this House, but Auntie Jane and Auntie Jenni ran the BABIES breastfeeding support group at Lanterns nursery, which still exists in Winchester, and I remember going to them one morning after we had had a dreadful night with our first, Emily—who is 15 now and still a challenge—and we were just desperate. The only thing that got us through to daylight was knowing that we were seeing Auntie Jane and Auntie Jenni in the morning. I remember taking my wife and Emily down to see them, and they provided amazing support, as do support groups all over this country. So, Auntie Jane and Auntie Jenni, thank you.
Dame Andrea Leadsom
That is lovely, and I pay tribute to the thousands of volunteers who provide breastfeeding support. My hon. Friend highlights perfectly one of the great challenges of becoming a new parent. When we are really struggling, there is a high correlation with mental health issues. When there is not enough support for women who want to breastfeed their babies but find they cannot do so, they suffer from feelings of guilt and feeling that they have failed and they are not good enough, and that lends itself to the problems of postnatal depression that are only too prevalent right across England.
So, to recap: midwifery, health visiting, mental health support, breastfeeding support, safeguarding support and disability support will be universally available in family hubs to help every family to give their baby the best start in life. Not only that, there will be universal-plus support for the most tricky and challenging issues such as the prospect of domestic violence. We know that up to 30% of domestic violence starts in pregnancy because of the partner’s feeling, “This person is going to love the baby more than they love me.” All these challenges that are brought out by pregnancy are quite desperate to be solved. We know that if we can get the hang of giving every baby the best start for life, that will transform our society.
I mentioned that the cost to our economy of late intervention is about £17 billion a year. The Maternal Mental Health Alliance’s study has shown a cost of around £8 billion a year for every new cohort of births as a direct result of the cost of poor maternal mental health in the perinatal period. The all-party parliamentary group on conception to age two—the 1,001 critical days—has demonstrated that school readiness results in a reduction in later problems such as the propensity of children to get into gangs, to have poor mental health and to fail to learn and do well at school. The 1970 cohort study showed, significantly later on, that only 18% of children in the bottom 25% academically at age five get one or more A-levels, compared with 60% of those in the top 25% at age five. What happens to a child in their earliest years follows them throughout their life, and the more we can do in that earliest period, the better, so the Government are totally on the right lines.
Kit Malthouse
I applaud my right hon. Friend’s work on the early years and, as she knows, I share her enthusiasm. We are talking today about the estimates for the Department for Education. What role does she think public health has to play in educating parents, particularly about our shared passion for attachment theory? We have been successful over the last few decades in educating parents about not smoking or drinking during pregnancy, about not smoking in the car with their children and about how to give them nutritious food. Much of that has been a huge success, but we have never really had a public health campaign based on the fundamental building block of emotional maturity in children, which comes from strong early attachments. When I was in the DFE, we were considering the idea of a big public health campaign to illustrate the importance of attachment, not just to women but to men as well. An attachment to a father is just as important as an attachment to a mother.
Dame Andrea Leadsom
My right hon. Friend is absolutely spot on.
That gives me the chance to mention the London School of Economics report in 2019, which illustrates the cost of insecure attachment. The cost is 50% higher if an infant is not securely attached to their mum than it is for a securely attached child, at around £4,000. If that baby is not securely attached to their dad, the cost can be four times higher than that, which obviously illustrates the importance of dads. My right hon. Friend is absolutely right to raise not only the importance of secure attachment but, very specifically, the importance of dads. The provision of holistic support on fathering is crucial.
My best start for life project is commissioning different bits of training, nationally and free to all early years practitioners, including on reflective parenting, so that everyone working with families, whether as a volunteer or as a professional, understands how reflective parenting can contribute to secure attachment. There is also video interaction guidance that demonstrates to families the good and the not so good, in a way that has been clearly evaluated. A lot of work is being done in the best start for life project to skill up everyone who is volunteering or working in the early years sector and to roll out support for families.
If a family are expecting a baby, they go to their family hub. If they want a book, they go to the library. If they want a bottle of milk, they go to the supermarket. We want family hubs to be a household name where people go if they have a child, and particularly if they have a baby. They should go whether they are rich or not so rich, whether they are young or old, and whether they have other caring responsibilities or not. We know that learning from each other in a supportive environment can be transformative.
I finish on childcare because, although my role as early years healthy development adviser is about nurturing support in the early years, most babies find themselves in a childcare setting when they are still very young—six months to a year old. The 1,001 critical days, the period from conception to the age of two, are a continuum, and it is when the vast majority of the lifelong blocks for emotional and physical health are laid.
Babies may spend a lot of that time in a nursery setting, and it seems to me that there are two issues. The first is quality, and it must be about parental choice. We need good-quality nurseries, but we also need choice for parents. If they want their mum to look after their baby, and if their mum is able, we should be willing to say, “Thank you very much, granny. You will get some sort of payment.” The payment should not be as if they are a trained nanny or nursery worker, but there should be some form of carer’s allowance or attendance allowance for grandparents who go part time to care for their grandchildren.